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89,209 results on '"Gastroenterology and Hepatology"'

3. Moving Toward Impact: An Introduction to Implementation Science for Gastroenterologists and Hepatologists

Author

Rogal, Shari S, Powell, Byron J, Chinman, Matthew, Group, Gastroenterology and Hepatology Implementation Research, Agbalajobi, Olufunso, Kanwa, Fasiha, Gonzalez, Rachel, Lamorte, Carolyn, Mellinger, Jessica, Morgan, Timothy, Neely, Brittney, Park, Angela, Patel, Arpan, Saini, Sameer, Waljee, Akbar, and Yakovchenko, Vera

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Evidence-Based Medicine, Gastroenterologists, Gastroenterology, Humans, Implementation Science, Research Design, Gastroenterology and Hepatology Implementation Research Group, Neurosciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics
Published
2020

4. Evaluating a Shared Decision Making Program for Crohn's Disease

Author

Agency for Healthcare Research and Quality (AHRQ), University of Pittsburgh, MOUNT SINAI HOSPITAL, Cedars-Sinai Medical Center, University of Maryland, Brigham and Women's Hospital, Thomas Jefferson University, University of Chicago, Atlanta Gastroenterology Associates, Long Island Clinical Research Associates, Center for Digestive and Liver Diseases, Charlotte Gastroenterology and Hepatology, Minnesota Gastroenterology, Ohio Gi and Liver Institute, Winthrop University Hospital, and Corey Siegel, Section Chief, Section of Gastroenterology

Published
2019

5. One Case Study: Many Questions, Not A Single Answer

Author

Djendov, Veselin R., 2nd Surgical Department, University Hospital, Burgas, Bulgaria, Khandzhiev, Stoyan, Gastroenterology and Hepatology Clinic, Achibadem City Clinic, Sofia, Bulgaria, Ivanov, Borislav, and 3 2nd Surgical Department, University Hospital, Burgas, BulgariaIntroductionEnergy

Subjects
Energy drinks, acute pancreatitis, pancreatic cyst, children
Published
2021

6. Austrian consensus on the definition and treatment of portal hypertension and its complications (Billroth II)

Author

Peck-Radosavljevic, Markus, Angermayr, Bernhard, Datz, Christian, Ferlitsch, Arnulf, Ferlitsch, Monika, Fuhrmann, Valentin, Häfner, Michael, Kramer, Ludwig, Maieron, Andreas, Payer, Berit, Reiberger, Thomas, Stauber, Rudolf, Steininger, Rudolf, Trauner, Michael, Thurnher, Siegfried, Ulbrich, Gregor, Vogel, Wolfgang, Zoller, Heinz, Graziadei, Ivo, and for the Austrian Society of Gastroenterology and Hepatology (ÖGGH)

Published
2013
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7. Risk factors associated with progression to intestinal complications of Crohn disease

Author

Baran, Bülent (ORCID 0000-0001-7966-2346 & YÖK ID 167583), Kayar, Yusuf; Örmeci, Aslı Çiftçibaşı; Akyuz, Filiz; Demir, Kadir; Beşışık, Fatih; Kaymakoğlu, Sabahattin, School of Medicine, Department of Internal Diseases, Gastroenterology and Hepatology, Baran, Bülent (ORCID 0000-0001-7966-2346 & YÖK ID 167583), Kayar, Yusuf; Örmeci, Aslı Çiftçibaşı; Akyuz, Filiz; Demir, Kadir; Beşışık, Fatih; Kaymakoğlu, Sabahattin, School of Medicine, and Department of Internal Diseases, Gastroenterology and Hepatology

Abstract

Background: crohn disease is a chronic bowel disease that causes serious complications. Prevalence of Crohn disease is increasing. Studies have shown that the behavior of the disease is not stable and severe complications secondary to behavior change over time have been shown. In this study, we aimed to evaluate the prognostic risk factors associated with phenotypic change in Crohn disease in a Turkish patient cohort. Methods: patients followed up from March 1986 to August 2011 were evaluated for demographic and clinical characteristics to determine possible risk factors and initial clinical phenotype of the disease based on the Montreal classification. The cumulative probabilities of developing stricturing or penetrating intestinal complications were estimated using the Kaplan-Meier analysis. Univariate and multivariate Cox-proportional hazard models were used to assess associations between baseline clinical characteristics and intestinal complications. Results: three hundred and thirty patients (mean age, 30.6 ± 11.1 years; 148 female) were included in the study. Mean follow-up duration was 7.4 ± 5.3 years (range: 1.0-25.0 years). At baseline 273 patients had inflammatory-type disease, 57 patients experienced stricturing/penetrating intestinal complications before or at the time of diagnosis. The cumulative probability of developing complicated disease was 37.4% at 5 years, 54.3% at 10 years, 78.8% at 25 years. Independent predictors associated with progression to intestinal complications were current smoking, perianal disease, extra-intestinal manifestations, and location of disease. Conclusions: location of disease is the most powerful indicator for the development of stenosis and penetrating complications in inflammatory-type disease. Patients with ileal involvement should be considered for more aggressive immunosuppressive therapy., NA

Published
2019

8. The role of pericytes in the pathophysiology multiple of sclerosis

Author

Şekerdağ, Emine; Atak, Dila; Yılmaz, Aysu; Zeybel, Müjdat (ORCID 0000-0002-1542-117X & YÖK ID 214694); Çakmak, Özgür Öztop (ORCID & YÖK ID); Gürsoy- Özdemir, Yasemin (ORCID 0000-0002-0860-8964 & YÖK ID 170592); Vural, Atay (ORCID 0000-0003-3222-874X & YÖK ID 182369), Tüzün, Erdem; Ulusoy, Canan; Küçükali, Cem, Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM), School of Medicine, Department of Gastroenterology and Hepatology; Department of Neurology, Şekerdağ, Emine; Atak, Dila; Yılmaz, Aysu; Zeybel, Müjdat (ORCID 0000-0002-1542-117X & YÖK ID 214694); Çakmak, Özgür Öztop (ORCID & YÖK ID); Gürsoy- Özdemir, Yasemin (ORCID 0000-0002-0860-8964 & YÖK ID 170592); Vural, Atay (ORCID 0000-0003-3222-874X & YÖK ID 182369), Tüzün, Erdem; Ulusoy, Canan; Küçükali, Cem, Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM), School of Medicine, and Department of Gastroenterology and Hepatology; Department of Neurology

Abstract

NA

Published
2019

9. Fabrication and characterization of large numerical aperture, high-resolution optical fiber bundles based on high-contrast pairs of soft glasses for fluorescence imaging

Author

Morova, Berna; Bavili, Nima; Yaman, Onur; Yiğit, Buket; Zeybel, Müjdat (ORCID 0000-0002-1542-117X & YÖK ID 214694); Kiraz, Alper (ORCID 0000-0001-7977-1286 & YÖK ID 22542), Aydın, Musa; Doğan, Buket; Kasztelanic, Rafal; Pysz, Dariusz; Buczynski, Ryszard, College of Sciences; School of Medicine; College of Engineering, Department of Physics; Department of Gastroenterology and Hepatology; Department of Electrical and Electronics Engineering, Morova, Berna; Bavili, Nima; Yaman, Onur; Yiğit, Buket; Zeybel, Müjdat (ORCID 0000-0002-1542-117X & YÖK ID 214694); Kiraz, Alper (ORCID 0000-0001-7977-1286 & YÖK ID 22542), Aydın, Musa; Doğan, Buket; Kasztelanic, Rafal; Pysz, Dariusz; Buczynski, Ryszard, College of Sciences; School of Medicine; College of Engineering, and Department of Physics; Department of Gastroenterology and Hepatology; Department of Electrical and Electronics Engineering

Abstract

Fabrication and characterization of flexible optical fiber bundles (FBs) with in-house synthesized high-index and low-index thermally matched glasses are presented. The FBs composed of around 15000 single-core fibers with pixel sizes between 1.1 and 10 mu m are fabricated using the stack-and-draw technique from sets of thermally matched zirconium-silicate ZR3, borosilicate SK222, sodium-silicate K209, and F2 glasses. With high refractive index contrast pair of glasses ZR3/SK222 and K209/F2, FBs with numerical apertures (NAs) of 0.53 and 0.59 are obtained, respectively. Among the studied glass materials, ZR3, SK222, and K209 are in-house synthesized, while F2 is commercially acquired. Seven different FBs with varying pixel sizes and bundle diameters are characterized. Brightfield imaging of a micro-ruler and a Convallaria majalis sample and fluorescence imaging of a dye-stained paper tissue and a cirrhotic mice liver tissue are demonstrated using these FBs. demonstrating their good potential for microendoscopic imaging. Brightfield and fluorescence imaging performance of the studied FBs are compared. For both sets of glass compositions, good imaging performance is observed for FBs, with core diameter and core-to-core distance values larger than 1.6 mu m and 2.3 mu m, respectively. FBs fabricated with K209/F2 glass pairs revealed better performance in fluorescence imaging due to their higher NA of 0.59., Smart Growth Operational Programme; EU-H2020-ICT-2014 grant MIREGAS: Programmable multi-wavelength Mid-IR source for gas sensing; Foundation for Polish Science Team Programme; European Regional Development Fund; European Union (European Union); H2020

Published
2019

10. Polyarthritis and its differential diagnosis

Author

Alpay Kanitez, Nilüfer (ORCID 0000-0003-1185-5816 & YÖK ID 239432), Çelik, Selda; Beş, Cemal, School of Medicine, Department of Internal Diseases, Gastroenterology and Hepatology, Alpay Kanitez, Nilüfer (ORCID 0000-0003-1185-5816 & YÖK ID 239432), Çelik, Selda; Beş, Cemal, School of Medicine, and Department of Internal Diseases, Gastroenterology and Hepatology

Abstract

Polyarthritis is a term used when at least five joints are affected with arthritis. Several different diseases ranging from rheumatoid arthritis to infection diseases can lead to polyarthritis. Anarnnesis, physical examination, laboratory findings and imaging methods are important tools to differential diagnosis., NA

Published
2019

11. Role of endoscopic interventions and electroincision in benign anastomotic strictures following colorectal surgery

Author

Aslan, Fatih (ORCID 0000-0002-1002-7202 & YÖK ID 219202), Acar, Turan; Acar, Nihan; Kamer, Erdinç; Ünsal, Belkıs; Hacıyanlı, Mehmet, School of Medicine, Department of Gastroenterology and Hepatology, Aslan, Fatih (ORCID 0000-0002-1002-7202 & YÖK ID 219202), Acar, Turan; Acar, Nihan; Kamer, Erdinç; Ünsal, Belkıs; Hacıyanlı, Mehmet, School of Medicine, and Department of Gastroenterology and Hepatology

Abstract

Background/aims: the anastomotic strictures are one of the most common colorectal surgery complications, and various endoscopic techniques have been defined. Balloon dilation is the most well-known and the simplest procedure. In this article, we aimed to present our series of endoscopic interventions and electroincision management for anastomotic strictures. Materials and methods: the files of 59 patients, who underwent colorectal surgery between January 2010 and September 2017 in our hospital and were diagnosed during the follow-up with anastomotic stricture, were analyzed. The outcomes of endoscopic interventions such as balloon dilation and electroincision were compared and reported. Results: the mean age of the 59 patients included in the study was 59.5 +/- 16.26 years. The primary operative indications were colorectal cancer in 46, inflammatory bowel disease in 7, diverticulum in 5, and penetrating trauma in one patient. Single- or multiple-balloon dilations were successful in 48 patients. Electroincision was performed in 11 patients because of the balloon dilation failure. None of the patients needed a secondary surgery. During the mean 33.75 months of the follow-up, the stricture recurred in seven patients who had undergone balloon dilation. Repeated balloon dilation was successful in these patients without any need for an additional surgical intervention. Conclusion: balloon dilation can be performed safely as the primary treatment option, because of its easy access and noninvasive application. Electroincision is also a safe and effective endoscopic technique that can be preferred especially when the balloon dilation fails., NA

Published
2019

12. The potential use of metabolic cofactors in treatment of NAFLD

Author

Ural, Dilek (ORCID 0000-0001-6419-0323 & YÖK ID 1057); Zeybel, Müjdat (ORCID 0000-0002-1542-117X & YÖK ID 214694), Mardinoğlu, Adil; Yüksel, Hatice Hilal; Uhlen, Mathias; Boren, Jan, School of Medicine, Department of Gastroenterology and Hepatology, Ural, Dilek (ORCID 0000-0001-6419-0323 & YÖK ID 1057); Zeybel, Müjdat (ORCID 0000-0002-1542-117X & YÖK ID 214694), Mardinoğlu, Adil; Yüksel, Hatice Hilal; Uhlen, Mathias; Boren, Jan, School of Medicine, and Department of Gastroenterology and Hepatology

Abstract

Non-alcoholic fatty liver disease (NAFLD) is caused by the imbalance between lipid deposition and lipid removal from the liver, and its global prevalence continues to increase dramatically. NAFLD encompasses a spectrum of pathological conditions including simple steatosis and non-alcoholic steatohepatitis (NASH), which can progress to cirrhosis and liver cancer. Even though there is a multi-disciplinary effort for development of a treatment strategy for NAFLD, there is not an approved effective medication available. Single or combined metabolic cofactors can be supplemented to boost the metabolic processes altered in NAFLD. Here, we review the dosage and usage of metabolic cofactors including l-carnitine, Nicotinamide riboside (NR), l-serine, and N-acetyl-l-cysteine (NAC) in human clinical studies to improve the altered biological functions associated with different human diseases. We also discuss the potential use of these substances in treatment of NAFLD and other metabolic diseases including neurodegenerative and cardiovascular diseases of which pathogenesis is linked to mitochondrial dysfunction., Knut and Alice Wallenberg Foundation

Published
2019

15. Web alert

Author

Naishadh Raghuwanshi, MD, MBA Saint Louis University School of Medicine, Division of Gastroenterology and Hepatology, 3660 Vista Avenue, St. Louis, MO 63110, USA. Email: nraghuwa@slu.edu

Published
2007
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16. Ivacaftor and symptoms of extra-oesophageal reflux in patients with cystic fibrosis and G551D mutation

Author

Zeybel, Müjdat (ORCID 0000-0002-1542-117X & YÖK ID 214694), Zeybel, Gemma L.; Pearson, Jeffrey P.; Krishnan, Amaran; Bourke, Stephen J.; Doe, Simon; Anderson, Alan; Faruqi, Shoaib; Morice, Alyn H.; Jones, Rhys; McDonnell, Melissa; Dettmar, Peter W.; Brodlie, Malcolm; Ward, Chris, School of Medicine, Department of Gastroenterology and Hepatology, Zeybel, Müjdat (ORCID 0000-0002-1542-117X & YÖK ID 214694), Zeybel, Gemma L.; Pearson, Jeffrey P.; Krishnan, Amaran; Bourke, Stephen J.; Doe, Simon; Anderson, Alan; Faruqi, Shoaib; Morice, Alyn H.; Jones, Rhys; McDonnell, Melissa; Dettmar, Peter W.; Brodlie, Malcolm; Ward, Chris, School of Medicine, and Department of Gastroenterology and Hepatology

Abstract

Background: Extra-oesophageal reflux (EOR) may lead to microaspiration in patients with cystic fibrosis (CF), a probable cause of deteriorating lung function. Successful clinical trials of ivacaftor highlight opportunities to understand EOR in a real world study. Methods: Data from 12 patients with CF and the G551D mutation prescribed ivacaftor (150 mg bd) was collected at baseline, 6, 26 and 52 weeks. The changes in symptoms of EOR were assessed by questionnaire (reflux symptom index (RSI) and Hull airway reflux questionnaire (HARQ)). Results: Six patients presented EOR at baseline (RSI > 13; median 13; range 2-29) and 5 presented airway reflux (HARQ >13; median 12; range 3 to 33). Treatment with ivacaftor was associated with a significant reduction of EOR symptoms (P < 0.04 versus baseline) denoted by the reflux symptom index and Hull airway reflux questionnaire. Conclusion: Ivacaftor treatment was beneficial for patients with symptoms of EOR, thought to be a precursor to microaspiration., BBSRC; UK Government Technology Strategy Board Knowledge Transfer Partnership; Medical Research Council Clinician Scientist Fellowship

Published
2017

17. Vildagliptin-induced acute pancreatitis without enzyme elevation

Author

Mungan, Zeynel (ORCID & YÖK ID 38313); Attila, Tan (ORCID & YÖK ID 118342), Kabaoğlu, Zeynep Ünal; Vural, Metin, Koç University Hospital, School of Medicine, Department of Gastroenterology and Hepatology, Mungan, Zeynel (ORCID & YÖK ID 38313); Attila, Tan (ORCID & YÖK ID 118342), Kabaoğlu, Zeynep Ünal; Vural, Metin, Koç University Hospital, School of Medicine, and Department of Gastroenterology and Hepatology

Abstract

We describe 2 patients with diabetes mellitus, presenting with upper abdominal pain. Although imaging findings were consistent with acute pancreatitis (AP), serum amylase and lipase levels were within normal limits. In both the cases, the only identifiable diagnostic culprit was vildagliptin. This is the first reported case of vildagliptin causing AP clinically and radiographically without elevated serum pancreatic enzymes. In conclusion, even when serum amylase and lipase levels are normal, AP should be kept in mind when making a differential diagnosis of patients with diabetes mellitus who present with abdominal pain and take dipeptidyl peptidase-4 (DPP-4) inhibitors., NA

Published
2017

18. Covering the cover

Author

Zeybel, Müjdat (ORCID 0000-0002-1542-117X & YÖK ID 214694), Koç University Hospital, School of Medicine, Department of Gastroenterology and Hepatology, Zeybel, Müjdat (ORCID 0000-0002-1542-117X & YÖK ID 214694), Koç University Hospital, School of Medicine, and Department of Gastroenterology and Hepatology

Abstract

NA

Published
2017

19. Gastroesophageal reflux disease and the relationship with Helicobacter pylori

Author

Mungan, Zeynel (ORCID & YÖK ID 38313), Şimşek, Binnur Pınarbaşı, Koç University Hospital, School of Medicine, Department of Gastroenterology and Hepatology, Mungan, Zeynel (ORCID & YÖK ID 38313), Şimşek, Binnur Pınarbaşı, Koç University Hospital, School of Medicine, and Department of Gastroenterology and Hepatology

Abstract

After Helicobacter pylori was identified, and its relationship with peptic ulcer disease was exactly shown, the relationship of this bacterium with gastroesophageal reflux disease (GERD) gained momentum and discussions continue to this day. We reviewed the literature for the relationship between H. pylori and GERD. According to the existing data, there is no relationship between GERD and H. pylori presence. Successful eradication therapy does not have an impact on the emergence or exacerbation of GERD. However Barrett's esophagus and esophageal adenocarcinoma are less frequent, especially in the presence of CagA positive H. pylori infections. Longterm use of proton pump inhibitor (PPI) may have an impact on the development of atrophy and/or intestinal metaplasia in H. pylori positive patients; therefore, H. pylori eradication is recommended in patients that should use long-term PPI. As a conclusion, H. pylori screening and the eradication decision should be independent of GERD, except for patients that will use long-term PPI., NA

Published
2017

20. Which drugs are risk factors for the development of gastroesophageal reflux disease?

Author

Mungan, Zeynel (ORCID & YÖK ID 38313), Şimşek, Binnur Pınarbaşı, Koç University Hospital, School of Medicine, Department of Gastroenterology and Hepatology, Mungan, Zeynel (ORCID & YÖK ID 38313), Şimşek, Binnur Pınarbaşı, Koç University Hospital, School of Medicine, and Department of Gastroenterology and Hepatology

Abstract

Gastroesophageal reflux disease (GERD), which is common in many communities, is associated with structural factors, eating habits, and the use of certain drugs. The use of such drugs can lead to the emergence of GERD and can also exacerbate existing reflux symptoms. These drugs can contribute to GERD by directly causing mucosal damage, by reducing lower esophageal sphincter pressure (LESP), or by affecting esophagogastric motility. In this article, we report our investigation of the relationships between GERD and medications within the scope of the "Turkish GERD Consensus Group." For the medication groups for which sufficient data were obtained (Figure 1), a systematic literature review in English was conducted using the keywords "gastroesophageal reflux" [MeSH Terms] and "anti-inflammatory agents, non-steroidal" [MeSH Terms], "gastroesophageal reflux" [MeSH Terms] and "acetylsalicylic acid" [MeSH Terms], "gastroesophageal reflux" [All Fields] and "estrogenic agents" [All Fields], "gastroesophageal reflux" [All Fields] and "progesterones" [All Fields], "gastroesophageal reflux" [All Fields] and "hormone replacement therapy" [All Fields], "gastroesophageal reflux" [MeSH Terms] and "diphosphonates" [MeSH Terms] OR "diphosphonates" [All Fields], "calcium channel blockers" [MeSH Terms] and "gastroesophageal reflux" [MeSH Terms], "gastroesophageal reflux" [MeSH Terms] and "nitrates" [MeSH Terms], "gastroesophageal reflux" [MeSH Terms] and "antidepressive agents" [MeSH Terms], "gastroesophageal reflux" [MeSH Terms] and "benzodiazepines" [MeSH Terms] and "hypnotic drugs" [MeSH Terms], "gastroesophageal reflux" [MeSH Terms] and "cholinergic antagonists" [MeSH Terms], "gastroesophageal reflux" [MeSH Terms] and " theophylline" [MeSH Terms], and " gastroesophageal reflux [MeSH Terms] AND "anti-asthmatic agents" [MeSH Terms]. The studies were analyzed and the results are presented here., NA

Published
2017

21. Diagnosis and treatment of iron deficiency anemia in patients with inflammatory bowel disease and gastrointestinal bleeding: iron deficiency anemia working group consensus report

Author

Çetiner, Mustafa, Akpınar, Hale; Keshav, Satish; Örmeci, Necati; Törüner, Murat, Koç University Hospital, School of Medicine, Department of Gastroenterology and Hepatology, Çetiner, Mustafa, Akpınar, Hale; Keshav, Satish; Örmeci, Necati; Törüner, Murat, Koç University Hospital, School of Medicine, and Department of Gastroenterology and Hepatology

Abstract

Iron deficiency (ID) and iron deficiency anemia (IDA) are important signs of gastrointestinal (GI) hemorrhage. Therefore, the evaluation of the GI tract should be a part of the diagnostic protocol in patients with IDA. GI hemorrhage is not a disease but a symptom, which might have different underlying causes. ID and IDA have significant negative impacts on the life quality and work ability, and they may lead to frequent hospitalization, delay of discharge, and increased healthcare costs. Therefore, an optimal management of the disease causing GI hemorrhage should include iron replacement therapy, along with the treatment of the underlying condition. IDA in inflammatory bowel disease (IBD) has received particular attention owing to its high prevalence, probably due to a number of other factors such as chronic hemorrhage, reduced dietary iron intake, and impaired absorption of iron. Historically, in IBD and in patients with GI hemorrhage, the diagnosis and management of IDA have been suboptimal. Options for iron replacement include oral and intravenous (IV) iron supplementation. Oral iron supplementation frequently results in GI side effects, and theoretically, it may exacerbate IBD activity; therefore, IV iron supplementation is usually considered in patients not responding to or not complying with oral iron supplementation or patients having low hemoglobin concentration and requiring prompt iron repletion. The aim of this report was to review the diagnostic and therapeutic considerations of IDA in IBD and GI hemorrhage with a multidisciplinary group of experts and to formulate necessary practical recommendations., NA

Published
2017

22. Outcome of sustained virological responders with histologically advanced chronic hepatitis C

Author

Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI, Division of Gastroenterology, University of California Irvine, Irvine, CA ; Gastroenterology Service, Veterans Affairs Long Beach Healthcare System, Long Beach, CA ; fax: 562-826-5436 ; VA Long Beach Healthcare System???11 (GI), 5901 East Seventh Street, Long Beach, CA 90822, Liver Diseases Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, New England Research Institutes, Watertown, MA, Hepatology Section, Virginia Commonwealth University Medical Center, Richmond, VA, Division of Gastroenterology and Hepatology, University of Colorado at Denver and Health Sciences Center, Denver, CO, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO, Departments of Medicine and Molecular and Structural Biology and The Liver-Biliary-Pancreatic Center, University of Connecticut Health Center, Farmington, CT, Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA, and the Department of Medicine, Harvard Medical School, Boston, MA, Division of Virology, Department of Laboratory Medicine, University of Washington, Seattle, WA, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, Morgan, Timothy R., Ghany, Marc G., Kim, Hae-Young, Snow, Kristin K., Shiffman, Mitchell L., De Santo, Jennifer L., Lee, William M., Di Bisceglie, Adrian M., Bonkovsky, Herbert L., Dienstag, Jules L., Morishima, Chihiro, Lindsay, Karen L., Lok, Anna S. F., Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI, Division of Gastroenterology, University of California Irvine, Irvine, CA ; Gastroenterology Service, Veterans Affairs Long Beach Healthcare System, Long Beach, CA ; fax: 562-826-5436 ; VA Long Beach Healthcare System???11 (GI), 5901 East Seventh Street, Long Beach, CA 90822, Liver Diseases Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, New England Research Institutes, Watertown, MA, Hepatology Section, Virginia Commonwealth University Medical Center, Richmond, VA, Division of Gastroenterology and Hepatology, University of Colorado at Denver and Health Sciences Center, Denver, CO, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO, Departments of Medicine and Molecular and Structural Biology and The Liver-Biliary-Pancreatic Center, University of Connecticut Health Center, Farmington, CT, Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA, and the Department of Medicine, Harvard Medical School, Boston, MA, Division of Virology, Department of Laboratory Medicine, University of Washington, Seattle, WA, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, Morgan, Timothy R., Ghany, Marc G., Kim, Hae-Young, Snow, Kristin K., Shiffman, Mitchell L., De Santo, Jennifer L., Lee, William M., Di Bisceglie, Adrian M., Bonkovsky, Herbert L., Dienstag, Jules L., Morishima, Chihiro, Lindsay, Karen L., and Lok, Anna S. F.

Abstract

Retrospective studies suggest that subjects with chronic hepatitis C and advanced fibrosis who achieve a sustained virological response (SVR) have a lower risk of hepatic decompensation and hepatocellular carcinoma (HCC). In this prospective analysis, we compared the rate of death from any cause or liver transplantation, and of liver-related morbidity and mortality, after antiviral therapy among patients who achieved SVR, virologic nonresponders (NR), and those with initial viral clearance but subsequent breakthrough or relapse (BT/R) in the HALT-C (Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis) Trial. Laboratory and/or clinical outcome data were available for 140 of the 180 patients who achieved SVR. Patients with nonresponse (NR; n = 309) or who experienced breakthrough or relapse (BT/R; n = 77) were evaluated every 3 months for 3.5 years and then every 6 months thereafter. Outcomes included death, liver-related death, liver transplantation, decompensated liver disease, and HCC. Median follow-up for the SVR, BT/R, and NR groups of patients was 86, 85, and 79 months, respectively. At 7.5 years, the adjusted cumulative rate of death/liver transplantation and of liver-related morbidity/mortality in the SVR group (2.2% and 2.7%, respectively) was significantly lower than that of the NR group (21.3% and 27.2%, P < 0.001 for both) but not the BT/R group (4.4% and 8.7%). The adjusted hazard ratio (HR) for time to death/liver transplantation (HR = 0.17, 95% confidence interval [CI] = 0.06-0.46) or development of liver-related morbidity/mortality (HR = 0.15, 95% CI = 0.06-0.38) or HCC (HR = 0.19, 95% CI = 0.04-0.80) was significant for SVR compared to NR. Laboratory tests related to liver disease severity improved following SVR. Conclusion: Patients with advanced chronic hepatitis C who achieved SVR had a marked reduction in death/liver transplantation, and in liver-related morbidity/mortality, although they remain at risk for HCC. (H EPATOLOGY 2010;)

Published
2010

23. Public health impact of antiviral therapy for hepatitis C in the United States

Author

Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI ; fax: 734-936-8944. ; Division of Gastroenterology and Hepatology, University of Michigan Health System, 7C27 NIB, 300 N. Ingalls, Ann Arbor, MI 48109, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, Volk, Michael L., Tocco, Rachel, Saini, Sameer, Lok, Anna S. -F., Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI ; fax: 734-936-8944. ; Division of Gastroenterology and Hepatology, University of Michigan Health System, 7C27 NIB, 300 N. Ingalls, Ann Arbor, MI 48109, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, Volk, Michael L., Tocco, Rachel, Saini, Sameer, and Lok, Anna S. -F.

Abstract

Despite dramatic improvements in antiviral therapy for hepatitis C, there is reason to believe that the uptake of antiviral therapy remains limited. The aims of this study were to determine the number of patients being treated with antiviral therapy in the U.S., to estimate the public health impact of these treatment patterns, and to identify barriers to treatment for patients with hepatitis C. Data on the number of new patient pegylated interferon prescriptions each year, from 2002???2007, was obtained from Wolters Kluwer Inc., which maintains an electronic audit of pharmacies nationwide. A Markov model was created of the population with chronic hepatitis C in the U.S. from 2002 to 2030, and was used to estimate the number of liver-related deaths caused by hepatitis C that will be prevented by current treatment patterns. The National Health and Nutrition Evaluation Survey (NHANES) Hepatitis C Follow-Up Questionnaire was used to investigate reasons for lack of treatment and to identify strategies for improving access. Approximately 663,000 patients received antiviral therapy between 2002 and 2007, and treatment rates appear to be declining. If this trend continues, only 14.5% of liver-related deaths caused by hepatitis C from 2002???2030 will be prevented by antiviral therapy. Results from the NHANES questionnaire suggest that the primary barrier to treatment is lack of diagnosis, with 69/133 (adjusted proportion 49%) of respondents previously unaware that they had hepatitis C. Conclusion: Efforts to improve rates of diagnosis and treatment will be required if the future public health burden of hepatitis C is to be ameliorated. (H EPATOLOGY 2009.)

Published
2010

24. SPINK1, macrophages et cellules progénitrices du foie: de nouvelles pistes pour stimuler la régénération dans l'hépatite alcoolique?

Author

UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Service de gastro-entérologie, Hôpitaux Universitaires de Genève - Gastroenterology and Hepatology, Lanthier, Nicolas, Spahr, Laurent, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Service de gastro-entérologie, Hôpitaux Universitaires de Genève - Gastroenterology and Hepatology, Lanthier, Nicolas, and Spahr, Laurent

Abstract

Cet article discute des nouveaux facteurs de bon pronostic identifiés dans l’hépatite alcoolique. Outre la prolifération des hépatocytes - phénomène évident mais pouvant être compromis en cas d’atteinte sévère du foie -, la prolifération des cellules progénitrices est désormais associée à un meilleur pronostic. Le rôle des macrophages hépatiques et de facteurs de croissance comme l'HGF, ou de prolifération comme le SPINK1 ou le TWEAK, est également discuté.

Published
2016

25. Fecalith causing mechanical bowel obstruction managed with intracorporeal lithotripsy

Author

Attila, Tan (ORCID & YÖK ID 118342), Kabaoğlu, Burçak; Köymen, Tamer; Kabaoglu, Zeynep Ünal, School of Medicine, Department of Gastroenterology and Hepatology, Attila, Tan (ORCID & YÖK ID 118342), Kabaoğlu, Burçak; Köymen, Tamer; Kabaoglu, Zeynep Ünal, School of Medicine, and Department of Gastroenterology and Hepatology

Abstract

NA

Published
2016

26. Effect of human immunodeficiency virus infection on hepatitis C virus infection in hemophiliacs

Author

From the Section of Gastroenterology and Hepatology, and Hematology and Oncology, Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana; Chiron Corporation, Emeryville, California; Division of Gastroenterology, University of Michigan Medical Center, 3912 Taubman Center, Box 0362, 48109, Ann Arbor, Michigan, From the Section of Gastroenterology and Hepatology, and Hematology and Oncology, Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana; Chiron Corporation, Emeryville, California, Ann Arbor, Sanchez-Pescador, R., Leissinger, C., Lagier, R., Lok, A.S.F., Ghany, Marc G., From the Section of Gastroenterology and Hepatology, and Hematology and Oncology, Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana; Chiron Corporation, Emeryville, California; Division of Gastroenterology, University of Michigan Medical Center, 3912 Taubman Center, Box 0362, 48109, Ann Arbor, Michigan, From the Section of Gastroenterology and Hepatology, and Hematology and Oncology, Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana; Chiron Corporation, Emeryville, California, Ann Arbor, Sanchez-Pescador, R., Leissinger, C., Lagier, R., Lok, A.S.F., and Ghany, Marc G.

Abstract

Chronic liver disease due to hepatitis C virus (HCV) infection is a major problem in hemophiliacs. Recent reports suggested that hemophiliacs coinfected with hepatitis C virus and human immunodeficiency virus (HIV) have an increased incidence of liver failure but the mechanism of accelerated liver injury is not clear. We tested plasma from 100 hemophiliacs for anti-HCV by second generation ELISA, anti-HIV by EIA, and HCV RNA and HIV RNA by branched DNA and polymerase chain reaction assays to determine if hemophiliacs coinfected with HCV and HIV have higher HCV RNA levels and more active liver disease. Seventy-nine (79%) patients were anti-HCV positive, of whom 85% were HCV RNA positive. None of the anti-HCV-negative patients had detectable HCV RNA in plasma. Forty-two (42%) patients were anti-HIV positive, of whom 47% had detectable HIV RNA. All the anti-HIV-positive patients were also anti-HCV positive. The prevalence of both anti-HCV and anti-HIV increased significantly with age. There was no difference in HCV RNA levels between anti-HIV-positive and anti-HIV-negative patients (mean: 21??4 vs 18??5 Meq/ml), although HCV RNA levels were significantly higher in anti-HIV-positive patients with CD4 counts<200/mm 3 (P =0.008). There was an inverse correlation between HCV RNA levels and CD4 counts but no correlation was found between HCV RNA and serum aminotransferase levels. We found a high prevalence of HCV and HIV coinfection in our hemophiliacs. Hepatitis C virus replication appears to be increased in patients with severe immunodeficiency secondary to progressive HIV infection. However, there was no correlation between HCV RNA and serum ALT level, suggesting that HCV is not directly cytopathic.

Published
2006

27. 原発性肝がんに対するシスプラチン・リピオドール療法時の有害事象調査

Author

三重大学医学部附属病院薬剤部:(現)日立病院機構名古屋医療センター薬剤科, 三重大学医学部附属病院薬剤部, 三重大学医学部附属病院消化器・肝臓内科, 三重大学医学部附属病院放射線治療科, Department of Pharmacy, Mie University Hospital, Department of Gastroenterology and Hepatology, Mie University Hospital, Department of Radiology, Mie University Hospital, Miyazawa, Kenji, Sekoguchi, Noriko, Iwamoto, Takuya, Muraki, Yuichi, Tanaka, Hideaki, Iwasa, Motoh, Yamakado, Kouichiro, Takeda, Kan, Takei, Yoshiyuki, Okuda, Masahiro, 宮澤, 憲治, 世古口, 典子, 岩本, 卓也, 村木, 優一, 田中, 秀明, 岩佐, 元雄, 山門, 享一郎, 竹田, 寛, 竹井, 謙之, 奥田, 真弘, 三重大学医学部附属病院薬剤部:(現)日立病院機構名古屋医療センター薬剤科, 三重大学医学部附属病院薬剤部, 三重大学医学部附属病院消化器・肝臓内科, 三重大学医学部附属病院放射線治療科, Department of Pharmacy, Mie University Hospital, Department of Gastroenterology and Hepatology, Mie University Hospital, Department of Radiology, Mie University Hospital, Miyazawa, Kenji, Sekoguchi, Noriko, Iwamoto, Takuya, Muraki, Yuichi, Tanaka, Hideaki, Iwasa, Motoh, Yamakado, Kouichiro, Takeda, Kan, Takei, Yoshiyuki, Okuda, Masahiro, 宮澤, 憲治, 世古口, 典子, 岩本, 卓也, 村木, 優一, 田中, 秀明, 岩佐, 元雄, 山門, 享一郎, 竹田, 寛, 竹井, 謙之, and 奥田, 真弘

Abstract

Transcatheter arterial embolization (TAB) and transcatheter arterial infusion (TAI) using cisplatin suspended in Lipiodol® Ultra-Fluide (Cisplatin/Lipiodol) are considered to be useful tumor-targeting therapies for hepatocellular carcinoma. However, little information is available on adverse events due to injection of Cisplatin/Lipiodol because the combined use Lipiodol and Cisplatin has not been approved by the Japanese government yet. Upon investigating the frequency and time of onset of adverse events following injection of Cisplatin/Lipiodol in 16 in-patients at Mie University Hospital, the frequency of the subjective symptoms of stomachache including epigastrium ache (75.0%), nausea or vomiting (50.0%), fever (50.0%), and gastric region discomfort (37.5%) was observed to be high. Further, leucocytes and neutrophils increased 2 days after injection (p< 0.001) and the onset of thrombocytopenia was much earlier than that following injection of Cisplatin alone. Severe adverse events defined as grade 3 or 4 in the Common Toxicity Criteria for Adverse Events Version 3.0 (JCOG/JSCO version, National Cancer Institute) were observed in 12 patients. These results suggest that great caution should be exercised with respect to adverse events occurring during Cisplatin/Lipiodol therapy.

Published
2013

28. Excess mortality in patients with advanced chronic hepatitis C treated with long-term peginterferon

Author

Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, From the Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO ; Department of Internal Medicine, Saint Louis University School of Medicine; 1402 South Grand Blvd., St. Louis, MO 63104, New England Research Institutes, Watertown, MA, Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA ; Department of Medicine, Harvard Medical School, Boston, MA, Liver Institute of Virginia, Bon Secours Health System, Newport News, VA, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD ; Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Department of Medicine, University of Connecticut Health Center, Farmington, CT ; Carolinas Medical Center,Charlotte, NC, Division of Virology, Department of Laboratory Medicine, University of Washington, Seattle, WA, Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, Division of Gastroenterology, University of California, Irvine, Irvine, CA ; Gastroenterology Service, VA Long Beach Healthcare System, Long Beach, CA, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Bisceglie, Adrian M., Stoddard, Anne M., Dienstag, Jules L., Shiffman, Mitchell L., Seeff, Leonard B., Bonkovsky, Herbert L., Morishima, Chihiro, Wright, Elizabeth C., Snow, Kristin K., Lee, William M., Fontana, Robert J., Morgan, Timothy R., Ghany, Marc G., Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, From the Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO ; Department of Internal Medicine, Saint Louis University School of Medicine; 1402 South Grand Blvd., St. Louis, MO 63104, New England Research Institutes, Watertown, MA, Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA ; Department of Medicine, Harvard Medical School, Boston, MA, Liver Institute of Virginia, Bon Secours Health System, Newport News, VA, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD ; Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Department of Medicine, University of Connecticut Health Center, Farmington, CT ; Carolinas Medical Center,Charlotte, NC, Division of Virology, Department of Laboratory Medicine, University of Washington, Seattle, WA, Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, Division of Gastroenterology, University of California, Irvine, Irvine, CA ; Gastroenterology Service, VA Long Beach Healthcare System, Long Beach, CA, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Bisceglie, Adrian M., Stoddard, Anne M., Dienstag, Jules L., Shiffman, Mitchell L., Seeff, Leonard B., Bonkovsky, Herbert L., Morishima, Chihiro, Wright, Elizabeth C., Snow, Kristin K., Lee, William M., Fontana, Robert J., Morgan, Timothy R., and Ghany, Marc G.

Abstract

Chronic hepatitis C virus infection can cause chronic liver disease, cirrhosis and liver cancer. The Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) Trial was a prospective, randomized controlled study of long-term, low-dose peginterferon therapy in patients with advanced chronic hepatitis C who failed to respond to a previous course of optimal antiviral therapy. The aim of this follow-up analysis is to describe the frequency and causes of death among this cohort of patients. Deaths occurring during and after the HALT-C Trial were reviewed by a committee of investigators to determine the cause of death and to categorize each death as liver- or nonliver-related and as related or not to complications of peginterferon. Rates of liver transplantation were also assessed. Over a median of 5.7 years, 122 deaths occurred among 1,050 randomized patients (12%), of which 76 were considered liver-related (62%) and 46 nonliver-related (38%); 74 patients (7%) underwent liver transplantation. At 7 years the cumulative mortality rate was higher in the treatment compared to the control group (20% versus 15%, P = 0.049); the primary difference in mortality was in patients in the fibrosis compared to the cirrhosis stratum (14% versus 7%, P = 0.01); comparable differences were observed when liver transplantation was included. Excess mortality, emerging after 3 years of treatment, was related largely to nonliver-related death; liver-related mortality was similar in the treatment and control groups. No specific cause of death accounted for the excess mortality and only one death was suspected to be a direct complication of peginterferon. Conclusion: Long-term maintenance peginterferon in patients with advanced chronic hepatitis C is associated with an excess overall mortality, which was primarily due to nonliver-related causes among patients with bridging fibrosis. (H EPATOLOGY 2011;)

Published
2011

29. Impact of Virologic Breakthrough and HBIG Regimen on Hepatitis B Recurrence After Liver Transplantation

Author

Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, University of California, Los Angeles, CA, Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, CA, University of Miami, Miami, FL, Virginia Commonwealth University, Richmond, VA, Columbia Presbyterian Medical Center, New York, NY, Yale University School of Medicine, New Haven, CT, University of Florida, Gainesville, FL, University of Pennsylvania, Philadelphia, PA, Mayo Clinic, Rochester, MN, Cedars Sinai Medical Center, Los Angeles, CA, University of Virginia, Charlottesville, VA, Degertekin, B., Han, Steven-Huy B., Keeffe, E. B., Schiff, E. R., Luketic, V. A., Brown, R. S. Jr., Emre, S., Soldevila-Pico, C., Reddy, K. R., Ishitani, M. B., Tran, T. T., Pruett, T. L., Lok, A. S. F., Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, University of California, Los Angeles, CA, Division of Gastroenterology and Hepatology, Stanford University Medical Center, Stanford, CA, University of Miami, Miami, FL, Virginia Commonwealth University, Richmond, VA, Columbia Presbyterian Medical Center, New York, NY, Yale University School of Medicine, New Haven, CT, University of Florida, Gainesville, FL, University of Pennsylvania, Philadelphia, PA, Mayo Clinic, Rochester, MN, Cedars Sinai Medical Center, Los Angeles, CA, University of Virginia, Charlottesville, VA, Degertekin, B., Han, Steven-Huy B., Keeffe, E. B., Schiff, E. R., Luketic, V. A., Brown, R. S. Jr., Emre, S., Soldevila-Pico, C., Reddy, K. R., Ishitani, M. B., Tran, T. T., Pruett, T. L., and Lok, A. S. F.

Abstract

The availability of hepatitis B immune globulin (HBIG) and several oral antiviral therapies has reduced but not eliminated hepatitis B virus (HBV) recurrence. We aimed to determine the rate of HBV recurrence after orthotopic liver transplantation (OLT) in relation to virologic breakthrough pre-OLT and HBIG regimens post-OLT. Data from the NIH HBV-OLT database were analyzed. A total of 183 patients transplanted between 2001 and 2007 followed for a median of 42 months (range 1???81) post-OLT were studied. At transplant, 29% were hepatitis B e antigen (HBeAg) (+), 38.5% had HBV DNA > 5 log 10 copies/mL, 74% were receiving antiviral therapy. Twenty-five patients experienced virologic breakthrough before OLT. Post-OLT, 26%, 22%, 40% and 12% of patients received intravenous (IV) high-dose, IV low-dose, intramuscular low-dose and a finite duration of HBIG, respectively as maintenance prophylaxis. All but two patients also received antiviral therapy. Cumulative rates of HBV recurrence at 1 and 5 years were 3% and 9%, respectively. Multivariate analysis showed that listing HBeAg status and HBV DNA level at OLT were the only factors associated with HBV recurrence. In conclusion, low rates of HBV recurrence can be accomplished with all the HBIG regimens used when combined with antiviral therapy including patients with breakthrough pre-OLT as long as rescue therapy is administered pre- and post-OLT.

Published
2011

30. Systematic Review on the Management of Chronic Constipation in North America

Author

Division of Gastroenterology, University of Michigan School of Medicine, and Center for Excellence in Health Services Research, Veterans Affairs Medical Center, Ann Arbor, MI, Division of Gastroenterology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, Division of Gastroenterology, Saint Louis University School of Medicine, St. Louis, MO, Department of Medicine and Alimentary Pharmabiotic Center, National University of Ireland, Cork, Ireland, Division of Gastroenterology, Baylor University Medical Center, Dallas, TX, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, Brandt, Lawrence J., Prather, Charlene M., Quigley, Eamonn M. M., Schiller, Lawrence R., Schoenfeld, Philip, Talley, Nicholas J., Division of Gastroenterology, University of Michigan School of Medicine, and Center for Excellence in Health Services Research, Veterans Affairs Medical Center, Ann Arbor, MI, Division of Gastroenterology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, Division of Gastroenterology, Saint Louis University School of Medicine, St. Louis, MO, Department of Medicine and Alimentary Pharmabiotic Center, National University of Ireland, Cork, Ireland, Division of Gastroenterology, Baylor University Medical Center, Dallas, TX, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, Brandt, Lawrence J., Prather, Charlene M., Quigley, Eamonn M. M., Schiller, Lawrence R., Schoenfeld, Philip, and Talley, Nicholas J.

Published
2010

31. Variants in interferon-alpha pathway genes and response to pegylated interferon-Alpha2a plus ribavirin for treatment of chronic hepatitis C virus infection in the hepatitis C antiviral long-term treatment against cirrhosis trial

Author

Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Division of Gastroenterology, University of California - Irvine, Irvine, CA, and Gastroenterology Service, VA Long Beach Healthcare System, Long Beach, CA, Departments of Medicine and The Liver-Biliary-Pancreatic Center, University of Connecticut Health Center, Farmington, CT, and Carolinas Medical Center, Charlotte, NC, New England Research Institutes, Watertown, MA, Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Core Genotyping Facility, NCI/Division of Cancer Epidemiology and Genetics, Advanced Technology Program, SAIC-Frederick Inc., NCI-Frederick, Frederick, MD, Department of Medicine, Johns Hopkins University, Baltimore, MD, Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick Inc., NCI-Frederick Inc., Frederick, MD, Computer Sciences Corp., Rockville, MD, Hepatology Section, Virginia Commonwealth University Medical Center, Richmond, VA, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Virology Division, Department of Laboratory Medicine, University of Washington, Seattle, WA, Gastrointestinal Unit, Medical Services, Massachusetts General Hospital, and the Department of Medicine, Harvard Medical School, Boston, MA, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD ; fax: 301-480-1917. ; 6120 Executive Boulevard, Room 6111, MSC 7246, Rockville, MD 20892, Welzel, Tania Mara, Morgan, Timothy R., Bonkovsky, Herbert L., Naishadham, Deepa, Pfeiffer, Ruth M., Wright, Elizabeth C., Hutchinson, Amy A., Crenshaw, Andrew T., Bashirova, Arman, Carrington, Mary, Dotrang, Myhanh, Sterling, Richard K., Lindsay, Karen L., Fontana, Robert J., Lee, William M., Di Bisceglie, Adrian M., Ghany, Marc G., Gretch, David R., Chanock, Stephen J., Chung, Raymond T., O'Brien, Thomas R., Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Division of Gastroenterology, University of California - Irvine, Irvine, CA, and Gastroenterology Service, VA Long Beach Healthcare System, Long Beach, CA, Departments of Medicine and The Liver-Biliary-Pancreatic Center, University of Connecticut Health Center, Farmington, CT, and Carolinas Medical Center, Charlotte, NC, New England Research Institutes, Watertown, MA, Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Core Genotyping Facility, NCI/Division of Cancer Epidemiology and Genetics, Advanced Technology Program, SAIC-Frederick Inc., NCI-Frederick, Frederick, MD, Department of Medicine, Johns Hopkins University, Baltimore, MD, Cancer and Inflammation Program, Laboratory of Experimental Immunology, SAIC-Frederick Inc., NCI-Frederick Inc., Frederick, MD, Computer Sciences Corp., Rockville, MD, Hepatology Section, Virginia Commonwealth University Medical Center, Richmond, VA, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Virology Division, Department of Laboratory Medicine, University of Washington, Seattle, WA, Gastrointestinal Unit, Medical Services, Massachusetts General Hospital, and the Department of Medicine, Harvard Medical School, Boston, MA, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD ; fax: 301-480-1917. ; 6120 Executive Boulevard, Room 6111, MSC 7246, Rockville, MD 20892, Welzel, Tania Mara, Morgan, Timothy R., Bonkovsky, Herbert L., Naishadham, Deepa, Pfeiffer, Ruth M., Wright, Elizabeth C., Hutchinson, Amy A., Crenshaw, Andrew T., Bashirova, Arman, Carrington, Mary, Dotrang, Myhanh, Sterling, Richard K., Lindsay, Karen L., Fontana, Robert J., Lee, William M., Di Bisceglie, Adrian M., Ghany, Marc G., Gretch, David R., Chanock, Stephen J., Chung, Raymond T., and O'Brien, Thomas R.

Abstract

Combination treatment with pegylated-interferon-alpha (PEG IFN-??) and ribavirin, the current recommended therapy for chronic hepatitis C virus (HCV) infection, results in a sustained virological response (SVR) in only about half of patients. Because genes involved in the interferon-alpha pathway may affect antiviral responses, we analyzed the relationship between variants in these genes and SVR among participants in the Hepatitis C Antiviral Long-Term treatment Against Cirrhosis (HALT-C) trial. Patients had advanced chronic hepatitis C that had previously failed to respond to interferon-based treatment. Participants were treated with peginterferon-??2a and ribavirin during the trial. Subjects with undetectable HCV RNA at week 72 were considered to have had an SVR. Subjects with detectable HCV RNA at week 20 were considered nonresponders. We used TaqMan assays to genotype 56 polymorphisms found in 13 genes in the interferon-alpha pathway. This analysis compares genotypes for participants with an SVR to nonresponders. The primary analysis was restricted to European American participants because a priori statistical power was low among the small number (n = 131) of African American patients. We used logistic regression to control the effect of other variables that are associated with treatment response. Among 581 European American patients, SVR was associated with IFNAR1 IVS1-22G (adjusted odds ratio, 0.57; P = 0.02); IFNAR2 Ex2-33C (adjusted odds ratio, 2.09; P = 0.02); JAK1 IVS22+112T (adjusted odds ratio, 1.66; P = 0.04); and ADAR Ex9+14A (adjusted odds ratio, 1.67; P = 0.03). For the TYK2 -2256A promoter region variant, a borderline association was present among European American participants (OR, 1.51; P = 0.05) and a strong relationship among African American patients; all 10 with SVR who were genotyped for TYK2 -2256 carried the A variant compared with 68 of 120 (57%) nonresponders ( P = 0.006). Conclusion: Genetic polymorphisms in the interferon-?? pathway may

Published
2009

32. Addition of adult-to-adult living donation to liver transplant programs improves survival but at an increased cost

Author

Department of Surgery, University of Michigan, Ann Arbor, MI, Department of Medicine, University of Virginia, Charlottesville, VA ; Telephone: 434-243-2718; FAX: 434-244-7529 ; Division of Gastroenterology and Hepatology, University of Virginia Health System, P.O. Box 800708, Jefferson Park Avenue and Lee Street, MSB 2142, Charlottesville, VA 22908-0708, Department of Surgery, Northwestern University, Chicago, IL, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY, Department of Medicine, University of Virginia, Charlottesville, VA, Department of Medicine, University of Virginia, Charlottesville, VA ; Department of Health Sciences, University of Virginia, Charlottesville, VA, Northup, Patrick G., Abecassis, Michael M., Englesbe, Michael J., Emond, Jean C., Lee, Vanessa D., Stukenborg, George J., Tong, Lan, Berg, Carl L., Department of Surgery, University of Michigan, Ann Arbor, MI, Department of Medicine, University of Virginia, Charlottesville, VA ; Telephone: 434-243-2718; FAX: 434-244-7529 ; Division of Gastroenterology and Hepatology, University of Virginia Health System, P.O. Box 800708, Jefferson Park Avenue and Lee Street, MSB 2142, Charlottesville, VA 22908-0708, Department of Surgery, Northwestern University, Chicago, IL, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY, Department of Medicine, University of Virginia, Charlottesville, VA, Department of Medicine, University of Virginia, Charlottesville, VA ; Department of Health Sciences, University of Virginia, Charlottesville, VA, Northup, Patrick G., Abecassis, Michael M., Englesbe, Michael J., Emond, Jean C., Lee, Vanessa D., Stukenborg, George J., Tong, Lan, and Berg, Carl L.

Abstract

Using outcomes data from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study, we performed a cost-effectiveness analysis exploring the costs and benefits of living donor liver transplantation (LDLT). A multistage Markov decision analysis model was developed with treatment, including medical management only (strategy 1), waiting list with possible deceased donor liver transplantation (DDLT; strategy 2), and waiting list with possible LDLT or DDLT (strategy 3) over 10 years. Decompensated cirrhosis with medical management offered survival of 2.0 quality-adjusted life years (QALYs) while costing an average of $65,068, waiting list with possible DDLT offered 4.4-QALY survival and a mean cost of $151,613, and waiting list with possible DDLT or LDLT offered 4.9-QALY survival and a mean cost of $208,149. Strategy 2 had an incremental cost-effectiveness ratio (ICER) of $35,976 over strategy 1, whereas strategy 3 produced an ICER of $106,788 over strategy 2. On average, strategy 3 cost $47,693 more per QALY than strategy 1. Both DDLT and LDLT were cost-effective compared to medical management of cirrhosis over our 10-year study period. The addition of LDLT to a standard waiting list DDLT program is effective at improving recipient survival and preventing waiting list deaths but at a greater cost. Liver Transpl 15:148???162, 2009. ?? 2009 AASLD.

Published
2009

33. Interpretation of positive transcription-mediated amplification test results from polymerase chain reaction???negative samples obtained after treatment of chronic hepatitis C

Author

Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI, Virology Division, Department of Laboratory Medicine, University of Washington, Seattle, WA ; fax: 206-744-9858. ; Department of Laboratory Medicine, University of Washington, Box 359690, Seattle, WA 98104, Division of Gastroenterology, University of California???Irvine, Irvine, CA, and Gastroenterology Service, VA Long Beach Healthcare System, Long Beach, CA, Division of Digestive Diseases and Nutrition, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Virology Division, Department of Laboratory Medicine, University of Washington, Seattle, WA, Hepatology Section, Virginia Commonwealth University Medical Center, Richmond, VA, Section of Hepatology, Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Denver, CO, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, Gastrointestinal Unit (Medical Services), Massachusetts General Hospital and the Department of Medicine, Harvard Medical School, Boston, MA, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, New England Research Institutes, Watertown, MA, Morishima, Chihiro, Morgan, Timothy R., Everhart, James E., Wright, Elizabeth C., Apodaca, Minjun C., Gretch, David R., Shiffman, Mitchell L., Everson, Gregory T., Lindsay, Karen L., Lee, William M., Lok, Anna S. F., Dienstag, Jules L., Ghany, Marc G., Curto, Teresa M., Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI, Virology Division, Department of Laboratory Medicine, University of Washington, Seattle, WA ; fax: 206-744-9858. ; Department of Laboratory Medicine, University of Washington, Box 359690, Seattle, WA 98104, Division of Gastroenterology, University of California???Irvine, Irvine, CA, and Gastroenterology Service, VA Long Beach Healthcare System, Long Beach, CA, Division of Digestive Diseases and Nutrition, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, Virology Division, Department of Laboratory Medicine, University of Washington, Seattle, WA, Hepatology Section, Virginia Commonwealth University Medical Center, Richmond, VA, Section of Hepatology, Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Denver, CO, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, Gastrointestinal Unit (Medical Services), Massachusetts General Hospital and the Department of Medicine, Harvard Medical School, Boston, MA, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, New England Research Institutes, Watertown, MA, Morishima, Chihiro, Morgan, Timothy R., Everhart, James E., Wright, Elizabeth C., Apodaca, Minjun C., Gretch, David R., Shiffman, Mitchell L., Everson, Gregory T., Lindsay, Karen L., Lee, William M., Lok, Anna S. F., Dienstag, Jules L., Ghany, Marc G., and Curto, Teresa M.

Abstract

The Siemens VERSANT?? transcription-mediated amplification (TMA) assay is extremely sensitive for the detection of hepatitis C virus (HCV) RNA in serum. Eleven of 180 subjects in the Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) Trial who achieved polymerase chain reaction (PCR)-defined sustained virological response (SVR) at week 72 also had TMA-positive results from the same blood draw; six were positive on repeat testing. We report the follow-up on these 11 patients, and the reproducibility of TMA test results from PCR-negative samples in relationship to antiviral treatment outcome. Peginterferon and ribavirin treatment was initiated in 1145 prior interferon nonresponders with advanced hepatic fibrosis. Treatment was continued for 48 weeks if patients had undetectable HCV RNA by PCR at treatment week 20. Frozen serum samples from weeks 12, 20, 24, 48, and 72 were subsequently tested by TMA. Nine of the 11 patients returned for testing (median, 30 months after the week 72 visit), and all had undetectable HCV RNA by TMA and PCR. Among 759 PCR-negative samples obtained during treatment that were tested twice by TMA, 17% overall exhibited consistently positive results, and 21% exhibited inconsistently positive results. SVR was more likely if TMA was consistently negative than if consistently or inconsistently positive. With continued treatment, patients with inconsistently positive TMA results were more likely to become TMA-negative than TMA-positive ( P < 0.0001). Conclusion: In PCR-negative samples, positive TMA results may indicate the presence of low levels of HCV RNA. However, because patients with positive TMA results may achieve SVR, management decisions during therapy should not be based on a single positive TMA test result. (H EPATOLOGY 2008.)

Published
2008

34. Validity and Reliability of the Modified Manchester Health Questionnaire in Assessing Patients With Fecal Incontinence

Author

Pelvic Floor Disorders Network Data Coordinating Center, University of Michigan, Ann Arbor, Michigan, Division of Female Pelvic Medicine and Reconstructive Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Division of Female Pelvic Medicine and Reconstructive Surgery, Loyola University, Maywood, Illinois, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Ann Arbor, Ye, Wen, Kwon, Soo, Visco, Anthony G., Whitehead, William E., FitzGerald, Mary Pat, Pelvic Floor Disorders Network Data Coordinating Center, University of Michigan, Ann Arbor, Michigan, Division of Female Pelvic Medicine and Reconstructive Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Division of Female Pelvic Medicine and Reconstructive Surgery, Loyola University, Maywood, Illinois, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Ann Arbor, Ye, Wen, Kwon, Soo, Visco, Anthony G., Whitehead, William E., and FitzGerald, Mary Pat

Abstract

To date, no measures of fecal incontinence severity or its impact on quality of life have been validated for telephone interview. This study was designed to 1) compare responses of a self-administered and a telephone-administered Fecal Incontinence Severity Index; 2) compare a self-administered Fecal Incontinence Quality of Life Scale to the Manchester Health Questionnaire after modifying the latter for telephone administration and American English (Modified Manchester Health Questionnaire); 3) assess test-retest reliability of the telephone-administered Modified Manchester Health Questionnaire; and 4) assess the internal consistency of the Modified Manchester Health Questionnaire subscales.

Published
2006

36. Timing of Endoscopic Intervention for Acute Variceal Hemorrhage: an RCT (TEACH)

Author

The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, The first affiliated Hospital of Nanjing Medical University, Jiangsu Province, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Taixing People's Hospital, and Fangyu Wang, Director of Department of Gastroenterology and Hepatology

Published
2024

37. Alcoholic Hepatitis Network Observational Study

Author

National Institute on Alcohol Abuse and Alcoholism (NIAAA) and Samer Gawrieh, Co-Director, Alcoholic Hepatitis Network Data Coordinating Center and Associate Professor of Medicine Division of Gastroenterology and Hepatology

Published
2024

38. Role of the JNK signal transduction pathway in inflammatory bowel disease

Author

Praveen K Roy, Farzana Rashid, Jack Bragg, Jamal A Ibdah, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, null Columbia, null Missouri, and United States

Subjects
Kinase, business.industry, JNK Mitogen-Activated Protein Kinases, Gastroenterology, JNK Pathway, Inflammation, General Medicine, Inflammatory Bowel Diseases, medicine.disease, Inflammatory bowel disease, digestive system diseases, Blockade, Intestinal inflammation, Immunology, medicine, Humans, JNK signaling pathway, Topic Highlight, medicine.symptom, Signal transduction, business, Signal Transduction
Abstract

The c-Jun NH2-terminal Kinase (JNK) pathway represents one sub-group of the mitogen-activated protein (MAP) kinases which plays an important role in various inflammatory diseases states, including inflammatory bowel disease (IBD). Significant progress towards understanding the function of the JNK signaling pathway has been achieved during the past few years. Blockade of the JNK pathway with JNK inhibitors in animal models of IBD lead to resolution of intestinal inflammation. Current data suggest specific JNK inhibitors hold promise as novel therapies in IBD.

Published
2008

42. Effects of an Air Bolus on Primary Peristalsis

Author

Reza Shaker, MD, Associate Provost for Clinical and Translational Research, Senior Associate Dean and Director of the Clinical and Translational Science Institute of SE WI, and the Joseph E. Geenen Professor and Chief of Gastroenterology and Hepatology

Published
2024

43. Guidelines for the approach to outpatient children with acute diarrhoea.

Author

Guarino, A, Albano, F, and Working Group on Intestinal Infections of the Italian Society of Paediatric Gastroenterology and Hepatology

Subjects
DIARRHEA in children, ORAL rehydration therapy for children, MEDICAL societies, THERAPEUTICS, OUTPATIENT medical care, DIARRHEA, HOSPITAL care, ACUTE diseases
Abstract

Discusses the treatment protocol for outpatient children with acute diarrhea proposed by the Gastroenterology Group of the Italian Society of Pediatrics. Recommendations for hospitalization; Indications for microbiological investigations and treatment; Suggestion of oral rehydration and temporary withdrawal of milk; Refeeding after rehydration.

Published
2001
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44. Smectite in the treatment of acute diarrhea: a nationwide randomized controlled study of the Italian Society of Pediatric Gastroenterology and Hepatology (SIGEP) in collaboration with primary care pediatricians. SIGEP Study Group for Smectite in Acute Diarrhea.

Author

Guarino, Alfredo, Bisceglia, Massimo, Castellucci, Giuseppe, Iacono, Giuseppe, Casali, Luigi Gobio, Bruzzese, Eugenia, Musetta, Antonella, Greco, Luigi, Guarino, A, Bisceglia, M, Castellucci, G, Iacono, G, Casali, L G, Bruzzese, E, Musetta, A, Greco, L, and Italian Society of Pediatric Gastroenterology and Hepatology Study Group for Smectite in Acute Diarrhea

Published
2001

47. CBAS180 De-escalation Study

Author

Pentax Medical and Koen Munters, Research Fellow, MD, Gastroenterology and Hepatology

Published
2024

49. External Pharyngeal Exerciser and Dysphagia

Author

Reza Shaker, MD, Associate Provost for Clinical and Translational Research, Senior Associate Dean and Director of the Clinical and Translational Science Institute of SE WI, and the Joseph E. Geenen Professor and Chief of Gastroenterology and Hepatology

Published
2024

50. External Pharyngeal Exerciser and Pharyngeal Phase of Swallowing

Author

Reza Shaker, MD, Associate Provost for Clinical and Translational Research, Senior Associate Dean and Director of the Clinical and Translational Science Institute of SE WI, and the Joseph E. Geenen Professor and Chief of Gastroenterology and Hepatology

Published
2024

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