The American journal of gastroenterology
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Am. J. Gastroenterol. · Jul 2013
Predictors of colorectal cancer screening variation among primary-care providers and clinics.
Colorectal cancer (CRC) screening is underutilized. To effect change, we must understand reasons for underuse at multiple levels of the health-care system. We evaluated patient, provider, and clinic factors that predict variation in CRC screening among primary-care clinics and primary-care providers (PCPs). ⋯ Variation in CRC screening exists among primary-care clinics and providers within a single clinic. Predictors of variation can be identified at patient, provider, and clinic levels. Quality improvement interventions addressing CRC screening need to be directed at multiple levels of the health-care system.
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Am. J. Gastroenterol. · Jul 2013
Mast cell tryptase reduces junctional adhesion molecule-A (JAM-A) expression in intestinal epithelial cells: implications for the mechanisms of barrier dysfunction in irritable bowel syndrome.
The objective of this study was to investigate how mast cell tryptase may influence intestinal permeability and tight junction (TJ) proteins in vitro and explore translation to irritable bowel syndrome (IBS). ⋯ uced JAM-A expression in vitro appears to contribute to the underlying mechanisms of altered epithelial integrity in response to tryptase released from degranulating mast cells. In IBS, JAM-A expression was significantly reduced in the cecal epithelium and associated with abdominal pain severity. JAM-A may provide new insights into the underlying mechanisms in IBS.