- Global Burden of Disease Study 2016 – Lancet
- Proton Pump Inhibitors Decrease Phlebotomy Need in HFE Hemochromatosis: Double-Blind Randomized Placebo-Controlled Trial – Gastro
- Influence of Age and Eosinophilic Esophagits on Esophageal Distensibility in a Pediatric cohort – Am J Gastro
- Long-Term CRC Incidence After Negative Colonoscopy in the State of Utah: Teh effect of Family History. – Am J Gastro
- Fecal Incontinence Is associated with Mortality Among Older Adults with Complex Needs – Am J Gastro
- Screening for Occult Cancer in Patients with Unprovoked Venous Thromboembolism – Annals of IM
- The Durability of Antireflux Surgery – JAMA
- Association of prophylactic endotracheal intubation in critically ill patients with upper GI bleeds and cardiopulmonary unplanned events – GIE
- Age of red cells for transfusion and outcomes in critically ill adults. – NEJM
- The Natural History of Sever Acute Liver Injury – Am J Gastro
- Esophageal Dilation with either bougie or balloon technique as a treatment for eosinophilic esophagitis: a systematic review and meta-analysis – GIE
Show Notes for last two weeks of August 007
- Celiac Disease and Nonceliac Gluten Sensitivity – Jama
- Comparison of Infliximab and Adalimumab in Biologic-Naive Patients With Ulcerative Colitis: A Nationwide Danish Cohort Study – Clin Gastro Hep
- Use of Thiopurines During Conceptions and Pregnancy is Not Associated with Adverse Pregnancy Outcomes or Health of Infants at One year in a Prospective Study – CGH
- Efficacy of Rectal Tacrolimus for Induction Therapy in Patients With Resistant Ulcerative Proctitis – CGH
- Use of Liver Imaging and Biopsy in Clinical Practice – NEJM
- Hospital-Level Balloon Tamponade Use is Associated with Increased Mortality for All Patients Presenting with Acute Variceal Hemorrhage – Liver international
- Clinical Predictors of the Risk of Early Colectomy in Ulcerative Colitis: A Population-based Study – IBD journal
- High-Quality Diets Associate With Reduced Risk of Colorectal Cancer: Analyses of Diet Quality Indexes in the Multiethnic Cohort – CGH
- Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study – The Lancet
- Efficacy of dietary and physical activity intervention in non-alcoholic fatty liver disease: a systematic review. – BMJ – Gastro
- Safety of Adding Oats to a Gluten-Free Diet for Patients With Celiac Disease: Systematic Review and Meta-analysis of Clinical and Observational Studies – Gastro
- Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis – Gastro
- Undetectable negative tissue transglutaminase IgA antibodies predict mucosal healing in treated coeliac disease patients – Alimentary Phar and Ther
- Death of a Farm Worker After Exposure to Manure Gas in an Open Air Environment – MMWR
Show Notes for 2017 First two weeks of August 007
- The colonoscopist’s guide to the vocabulary of colorectal neoplasia: histology, morphology, and management – GIE
- Use of enteroscopy for the detection of malignant and premalignant lesions of the small bowel in complicated celiac disease: a meta-analysis – GIE
- Impact of cap-assisted colonoscopy on detection of proximal colon adenomas: systematic review and meta-analysis – GIE
- Outcomes and quality-of-life assessment after gastric per-oral endoscopic pyloromyotomy – GIE
- Randomized controlled trial of scleroligation versus band ligation alone for eradication of gastroesophageal varices – GIE
- Endoscopic multiple biopsy and rapid diagnosis by in situ fixation and histopathologic processing – GIE
- Diagnostic Accuracy of Fecal Immunochemical Test in Patients at Increased Risk of Colorectal Cancer: A Meta-analysis – Jama:Int Med
- Older Adults’ Views and Communication Preferences About Cancer Screening Cessation – Jama Int Med
- Celiac Disese and Nonceliac Gluten Sensitivity – A Review – JAMA
- Board Review Vignette: PPP Syndrome: Pancreatitis, Panniculitis, Polyarthritis – Am J Gastro
- EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection – Journal of Hepatology
- The impact of a Prior Diagnosis of Barrett’s Esophagus on Esophageal Adenocarcinoma Survival – Am J Gastro
- Old Farts – Fact or Fiction? Results From a Population-Based Survey of 16,000 Americans Examining the Association Between Age and Flatus – CGH
- Cost Utility Analysis of Topical Steroids Compared With Dietary Elimination for Treatment of Eosinophilic Esophagitis – CGH
- Incidence and Prevalence of Crohn’s Disease and Ulcerative Colitis in Olmsted County, Minnesota From 1970 Through 2010 – CGH
- Fecal Immunochemical Test Detects Sessile Serrated Adenomas and Polyps With a Low Level of Sensitivity – CGH
- Comparison of Two Intensive Bowel Cleansing Regimens in Patients With Previous Poor Bowel Preparation: A Randomized Controlled Study. – GIE
- Acute Fatty Liver Disease of Pregnancy: Updates in Pathogenesis, Diagnosis, and Management – ACG
- Disentangling the Association between Statins, Cholesterol, and Colorectal Cancer: A Nested Case-Control Study – PLOS Medicine
- Association of Gastric Acid Suppression With Recurrent Clostridium difficile InfectionA Systematic Review and Meta-analysis – JAMA Internal Med
- Amanita phalloides Mushroom Poisonings — Northern California, December 2016 – MMWR June 2017
- Wild Mushrooms: An Exclusive Delicacy or Last Meal – ACG
- Treatment of NASH: What Helps Beyond Weight Loss? – ACG
- Small intestinal bacterial overgrowth and Celiac disease: A systematic review with pooled-data analysis – Neurogastro & Motility
This one is a bit noisy. Not the Best Microphone. Sorry.
List of articles cited
- Tofacitinib as Induction and Maintenance Therapy for Ulcerative Colitis NEJM
- Thiazolidinediones and Advanced Liver Fibrosis in Nonalcoholic Steatohepatitis – Jama Internal Medicine
- Tenapanor Treatment of Patients With Constipation-Predominant Irritable Bowel Syndrome: A Phase 2, Randomized, Placebo-Controlled Efficacy and Safety Trial The AmJ of Gastro
Medication Management in the Pregnant IBD Patient The AmJ of Gastro
Central Neuromodulators for Treating Functional GI Disorders: A Primer The AmJ of Gastro
We often talk to
our patients with cirrhosis regarding the risk of HCC, and putting aside the debate as to the efficacy of screening for such, most of our patients get the ultrasound twice yearly, +/- AFP every so often, and we cross our fingers and hope for the best, given how non-existent effective therapy for HCC is (other than resection).
This article in CGH – which regained the title of my second most favorite GI journal this week, is an article from the Texan folks, discussing HCC in the absence of cirrhosis.
This is a review of the Veteran’s Affairs database (boy would I love to get my hands on that!), 2005-2011 diagnoses of HCC, which was limited to 1500 random charts (obtained from a total of 10,695 HCC diagnoses).
~80% of the patients diagnosed with HCC had cirrhosis. Which means ~20% did not. Who are these remaining folks?
Many had metabolic syndrome, NAFLD, but some had no risk factors whatsoever. It is interesting that in the cohort of 43 patients with what authors defined as “No cirrhosis – very high probability” – many still had some fibrosis.
In any case, logistic regression to look for associations and risk factors for HCC in absence of cirrhosis was conducted. Results:
NAFLD, HCV, HBV, Alcohol abuse, Metabolic syndrome, Others (hemochromatosis, autoimmune hepatitis, A1-AT deficiency). Idiopathic – only in 13 out of 194 patients!
- Glad to know that we are aware of major risk factors for HCC even in the absence of cirrhosis.
- No evidence as of yet to expand the risk pool to screen patients without evidence of cirrhosis.
- If chemoprevention is ever developed, now we know a good population to apply it in ( ex – Maybe Metformin?.
- It would be nice to have a large data dump of such patients on a national level, and include other variables in analysis, such as factors associated with good outcome or poor outcome. I suppose we can wait for the next paper.