Journal of clinical gastroenterology
-
J. Clin. Gastroenterol. · May 2008
Comparative StudyClinical significance of colonoscopic findings associated with colonic thickening on computed tomography: is colonoscopy warranted when thickening is detected?
To determine the utility of colonoscopy in the management of patients with abdominal pain found to have colonic thickening on computed tomography (CT). ⋯ On the basis of the rate of new diagnoses of colorectal carcinoma and IBD, we recommend colonoscopy be performed after clinical evaluation in patients with abdominal pain and colonic thickening on CT.
-
J. Clin. Gastroenterol. · May 2008
Review Meta AnalysisTransjugular intrahepatic portosystemic shunt versus endoscopic therapy in the secondary prophylaxis of variceal rebleeding in cirrhotic patients: meta-analysis update.
The aim of this study was to determine through meta-analysis the effects of transjugular intrahepatic portosystemic shunt (TIPS) for the reduction of variceal rebleeding (VRB). ⋯ TIPS is currently the first choice to prevent rebleeding except that TIPS is worse than endoscopic therapy for encephalopathy. An exploration of new approaches out of above complications will be of considerable clinical significance and be a challenge to clinicians.
-
J. Clin. Gastroenterol. · May 2008
Randomized Controlled Trial Comparative StudyHelicobacter pylori infection and development of gastric cancer in Korea: long-term follow-up.
Infection of Helicobacter pylori is viewed as a major driver of progression to the precancerous state or to gastric cancer. This study was performed to investigate the effect of H. pylori infection on gastric cancer development and to determine to what extent H. pylori eradication is likely to reduce the prevalence of gastric cancer. ⋯ The present study shows a close relationship between H. pylori infection and IM, and between IM and the development of gastric cancer. In addition, our finding suggests that chronic H. pylori infection looks like an important risk factor for the development of gastric cancer in Korea, where the prevalence of H. pylori remains high. This study indicates that to prevent gastric cancer H. pylori eradication is best performed before the development of IM.
-
J. Clin. Gastroenterol. · May 2008
Comparative StudyHyperhomocysteinemia in inflammatory bowel disease patients without past intestinal resections: correlations with cobalamin, pyridoxine, folate concentrations, acute phase reactants, disease activity, and prior thromboembolic complications.
Homocysteine is a sulfur-containing amino acid formed during the demethylation of methionine and high levels of this amino acid is a known risk factor for both arterial and also venous thromboembolic complications. Deficiencies of cobalamin, folate, and pyridoxine may predispose subjects to hyperhomocysteinemia, a common phenomenon in inflammatory bowel disease (IBD) patients. The aim of this study was to identify the prevalence, risk factors of hyperhomocysteinemia and its correlation with prior thromboembolic events in an IBD cohort without past intestinal resections. ⋯ IBD patients have a higher prevalence of hyperhomocysteinemia than do healthy controls and elevated homocysteine levels are independently associated with lower serum cobalamin, albumin levels and elevated erythrocyte sedimentation rate, and platelet count. There is no correlation between hyperhomocysteinemia and a history of prior thromboembolic events.
-
J. Clin. Gastroenterol. · Apr 2008
Comparative StudyHow physicians describe outcomes to HCV therapy: prevalence and meaning of "cure" during provider-patient in-office discussions of HCV.
How physicians convey information about hepatitis C virus (HCV) impacts patients' perceptions of treatment outcomes and informed therapy decisions. However, HCV patients reported difficulties communicating with their physicians in a recent study. Another study showed that 45% of patients did not understand projected response rates conveyed by providers, and patients with unfavorable projected treatment outcomes were more likely to lack understanding. ⋯ HCV dialogs are characterized by the prevalence of 'cure' and optimistic framing. These positive language attributes could potentially contribute to the misunderstanding regarding the projected response rates. During treatment outcome discussions, the physicians should attempt to (1) operate using the same definition of the therapy outcome as the patient, (2) balance medically accurate information with patient comprehension, and (3) consider possible consequences of discussing treatment options on the basis of message framing.