The American journal of gastroenterology
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Am. J. Gastroenterol. · Apr 2014
Randomized Controlled Trial Multicenter Study Comparative StudyA comparative study of sequential therapy and standard triple therapy for Helicobacter pylori infection: a randomized multicenter trial.
Studies conducted in large populations of patients and providing full information on Helicobacter pylori (H. pylori) antibiotic resistance are needed to determine the efficacy of sequential therapy (SQT) against this pathogen. This study compared eradication rates with SQT and standard triple therapy (STT), and evaluated the impact of antibiotic resistance on outcomes. ⋯ H. pylori eradication rates with STT and SQT were compromised by antibiotic resistance. SQT may be suitable in regions with high prevalence of isolated CLA-R, but it is unsatisfactory when both CLA-R and MET-R are present.
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Am. J. Gastroenterol. · Apr 2014
Comparative StudyThe Royal Free Hospital score: a calibrated prognostic model for patients with cirrhosis admitted to intensive care unit. Comparison with current models and CLIF-SOFA score.
Prognosis for patients with cirrhosis admitted to intensive care unit (ICU) is poor. ICU prognostic models are more accurate than liver-specific models. We identified predictors of mortality, developed a novel prognostic score (Royal Free Hospital (RFH) score), and tested it against established prognostic models and the yet unvalidated Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) model. ⋯ RFH score demonstrated good discriminative ability and calibration. Internal validation supports its generalizability. CLIF-SOFA did not perform better than RFH and the original SOFA. External validation of our model should be undertaken to confirm its clinical utility.
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Am. J. Gastroenterol. · Apr 2014
J. Edward Berk distinguished lecture: avoiding burnout: finding balance between work and everything else.
Burnout has been defined as "a state of mental exhaustion caused by one's professional life." Increasing evidence shows high rates of burnout among medical professionals, including gastroenterologists. Factors that contribute to burnout include work-home conflict and longer work hours. Among gastroenterologists, the risk for burnout seems to be highest during the first three years on the job after fellowship. Strategies to treat and prevent burnout include identifying and balancing personal and professional goals, shaping one's career to optimize meaning, identifying stressors, and nurturing wellness strategies.