Journal of clinical gastroenterology
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J. Clin. Gastroenterol. · Apr 2011
ReviewStool DNA screening for colorectal cancer: opportunities to improve value with next generation tests.
General adoption of the screening tests for colorectal cancer (CRC) by patients, health care professionals, medical centers, and third party payers rests on a favorable assessment of value. Reported cost-effectiveness estimates of stool DNA testing for CRC screening incorporated performance assumptions based on data from the first generation tests. Given the substantial technical advances in stool DNA testing that have occurred subsequently, estimates of value will need to be revisited. This review briefly examines the early cost-effectiveness estimates for stool DNA screening and looks ahead at how the next generation tests might improve such value estimates for CRC screening.
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J. Clin. Gastroenterol. · Apr 2011
Natural history of asymptomatic small gastric subepithelial tumors.
To assess the natural history of gastric subepithelial tumors (SETs) of ≤30 mm in size and to determine their optimal management. ⋯ Only 8.5% of gastric SETs of ≤30 mm in size showed significant changes at a median 24 months. SETs of 10 to 30 mm in size grew significantly more rapidly than SETs <10 mm.
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Paracoccidioidomycosis is the most prevalent mycosis in Latin America. Although the lungs are the primary site of infection, physicians often see patients because of disseminated disease. ⋯ Gastrointestinal disease can present as part of progressive dissemination of infection or as a result of local complications from a silent healing process. This review will summarize the salient features of gastrointestinal paracoccidioidomycosis.
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J. Clin. Gastroenterol. · Aug 2010
Randomized Controlled Trial Comparative StudyA full solid diet as the initial meal in mild acute pancreatitis is safe and result in a shorter length of hospitalization: results from a prospective, randomized, controlled, double-blind clinical trial.
To compare the safety and length of hospitalization (LOH) between a full solid diet as the initial meal for refeeding after mild acute pancreatitis (AP) as compared with 2 other diets. ⋯ Oral refeeding with a full solid diet in mild AP was well tolerated and resulted in a shorter LOH in patients without abdominal pain relapse.
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J. Clin. Gastroenterol. · Aug 2010
Case ReportsCoexisting hepatopulmonary syndrome and portopulmonary hypertension: implications for liver transplantation.
Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH) represent pulmonary complications of liver disease and portal hypertension. The underlying pathophysiology behind these entities is complex and involves different effects of vasoactive substances on the pulmonary vasculature, among them endothelin-1 and nitric oxide (NO). Hepatopulmonary syndrome results from vasodilation, intrapulmonary shunting, and hypoxia. ⋯ We present a case report in which these 2 processes with opposing pathologic mechanisms coexist in the same patient. We also conducted a literature search to identify other documented cases of coexisting hepatopulmonary syndrome and portopulmonary hypertension, common clinical features of these patients, and outcomes with or without treatment. Our case highlights the importance of recognizing the coexistence of these 2 disease processes, as they may occur simultaneously and affect the approach to treatment, including liver transplantation.