The latest medical research on Gastroenterology
The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about gastroenterology gathered by our medical AI research bot.
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Reply to comment: Proton Pump Inhibitor Use and Risk of Hepatocellular Carcinoma.Hepatology
We appreciate the comments by Lai on our study. We completely agree that proton pump inhibitor (PPI) use is not associated with an increased risk o...
Adjuvant Treatment of Hepatocellular Carcinoma: Prospect of Immunotherapy.Hepatology
Although patients undergo procedures with curative intent for early stage hepatocellular carcinoma (HCC), up to 70% of patients may have disease re...
A Positive Feedback Loop between Cancer Stem-Like Cells and Tumor- Associated Neutrophils Controls Hepatocellular Carcinoma Progression.Hepatology
Tumor-associated neutrophils (TANs) play a crucial role in tumor development and progression in the cancer microenvironment. Despite increased unde...
HNF4A is essential for the active epigenetic state at enhancers in mouse liver.Hepatology
Cell fate determination is influenced by interactions between master transcription factors (TFs) and cis-regulatory elements. Hepatocyte nuclear fa...
Gallbladder dyskinesia is associated with an impaired postprandial FGF19 response in critically ill patients.Hepatology
Critical illness is associated with a disturbed regulation of gastrointestinal hormones resulting in functional and metabolic anomalies. FGF19 is a...
HCV prevalence estimates among incarcerated persons.Hepatology
Hofmeister identified populations with heightened HCV prevalence, including 2.1M individuals incarcerated 12/31/16(1), estimating this population's...
Characteristics of impaired dendritic cell function in patients with hepatitis B virus infection.Hepatology
Dendritic cells are antigen-presenting cells with a central role in host immune response. This study analyzed gene expression and dendritic cell fu...
Reply to HCV prevalence estimates among incarcerated persons (Letter to the Editor regarding HEP-18-1268.R1).Hepatology
We appreciate Dr. Spaulding and colleagues' thoughtful commentary on our article. We used national data to provide the most accurate estimate possi...
Treating Hepatitis C in the Homeless at the Greater Los Angeles Veterans Affairs.Hepatology
Among the 250,000 homeless Veterans (HVs) that receive care in the Veterans Health Administration (VA), 13.4% have chronic hepatitis C virus (HCV) ...
Evaluation of a multifaceted intervention to reduce health disparities in hepatitis C screening: a pre-post analysis.Hepatology
Hepatitis C virus (HCV) testing in persons born from 1945 to 1965 has had limited adoption despite guidelines, particularly among racial/ethnic minorities and socioeconomically disadvantaged patients, who have a higher prevalence of disease burden. We examined the effectiveness of a multifaceted intervention to improve HCV screening in a large safety-net health system.
We performed a multifaceted intervention that included provider and patient education, an EMR-enabled best practice alert, and increased HCV treatment capacity. We characterized HCV screening completion before and after the intervention. To identify correlates of HCV screening, we performed logistic regression for the pre-intervention and post-intervention groups and generalized linear mixed model (GLMM) for patients observed in both pre- and post-intervention time-frame.
Before the intervention, 10.1% of 48,755 eligible baby boomer patients were screened. After the intervention, 34.6% of the 34,093 eligible baby boomers were screened (p=<.0001). Prior to the intervention, HCV screening was lower among older baby boomers and providers with large patient panels and higher in high-risk subgroups including those with signs of liver disease (e.g., elevated transaminases, thrombocytopenia), HIV-positive patients, and homeless patients. Post-intervention, we observed increased screening uptake in older baby boomers, providers with larger patient panel size, and patients with >1 prior primary care appointment.
Our multifaceted intervention significantly increased HCV screening, particularly among older patients, those engaged in primary care, and providers with large patient panels. This article is protected by copyright. All rights reserved.
Vitamin D deficiency in adult patients with ulcerative colitis: Prevalence and relationship with disease severity, extent, and duration.Indian Journal of Gastroenterology
Vitamin D plays a key role in gut immunity and maintenance of the mucosal barrier. Vitamin D deficiency (VDD) worsens ulcerative colitis (UC) and its supplementation ameliorates the disease in mouse models. The prevalence and predictors of VDD in UC are not known.
Consecutive patients with UC (n = 80) underwent clinical, endoscopic, and histological evaluation to assess the extent, severity using UC disease activity index (UCDAI) score, and duration of illness. An equal number of age and gender-matched healthy adults without any features of inflammatory bowel disease (IBD) living in the same latitude were identified as controls. The serum 25-hydroxy vitamin D3 level was estimated. The subjects were classified as deficient (< 20 ng/mL), insufficient (20-32 ng/mL), sufficient (32-80 ng/mL), and optimal (> 80 ng/mL) based on vitamin D levels. Chi-square test and Mann-Whitney U test were done to identify factors associated with vitamin D deficiency.
The patients and controls were similar in age and gender (40 ± 11.4 years, 51% male vs. 40 ± 12 years, 51% male; p = 1.000). Median vitamin D levels among patients were lower than the controls (18.1 ng/mL [IQR 14] vs. 32.5 ng/mL [IQR 36]; p < 0.001). Patients were more often VDD (56% vs. 40%) or insufficient (34% vs. 9%) and less often sufficient (9% vs. 40%) or optimal (1% vs. 11%), in contrast to controls (p < 0.001). Median vitamin D levels were lower in those with UCDAI > 6 (15 vs. 21 ng/mL; p = 0.01), having pancolitis (13 vs. 21 ng/mL, p = 0.01), and longer duration of illness > 2 years (13.8 vs. 20.8; p = 0.025). Vitamin D levels showed a negative correlation with frequency of stools (rho = - 0.244, p = 0.05), disease duration (rho = - 0.244, p = 0.007) and UCDAI score (r = - 0.348, p = 0.002).
VDD is highly prevalent among patients with UC. Patients with longer disease duration, more severe symptoms, and pancolitis are likely to have lower vitamin D levels.
The effectiveness of mindfulness meditation in relief of symptoms of depression and quality of life in patients with gastroesophageal reflux disease.Indian Journal of Gastroenterology
The role of psychological comorbidities in patients with gastroesophageal reflux disease (GERD), a common condition, still remains incompletely understood. Depression may intensify the symptoms and lower quality of life in these patients. In this study, we looked at the effectiveness of mindfulness-based stress reduction (MBSR) in relieving the symptoms of depression and the health-related quality of life of these patients.
A longitudinal, interventional open-label study was carried out on 60 patients with GERD and 60 controls. Zung Self-Rating Depression Scale (ZSDS) was used for assessing depression before and after the intervention. The GERD-Health-Related Quality of Life (GERD-HRQL) questionnaire was used to assess the health-related quality of life and the Freiburg Mindfulness Inventory (FMI) to quantify the amount of mindfulness over the study period. The correlation between the above variables was analyzed.
Compared with the group not receiving MBSR, the group receiving MBSR showed a greater decrease in the levels of depression indicated by changes in the ZSDS (p < 0.001). According to the GERD-HRQL questionnaire, mental health and social functioning significantly correlated with symptoms of depression and reduction in the levels of distress and in the improvement in health-related quality of life were greater in the group receiving MBSR (p < 0.001).
Depressive symptoms adversely influence GERD, reducing the overall quality of life. MBSR can be an effective modality in the alleviation of these symptoms and in reduction in the levels of distress in GERD patients.