Abstract:
BACKGROUND:Regular screening of cirrhotic patients for hepatocellular carcinoma (HCC) has been suboptimal, but there is little data regarding specific risk factors for reduced screening. METHODS:From 1996 to 2010, patients with cirrhosis were retrospectively identified from outpatient gastroenterology and primary care practices. Data was obtained from the diagnosis of cirrhosis until the time of elevated alpha-fetoprotein (AFP) or lesion suspicious for HCC, death, liver transplantation, or end of the data collection period. Recommended screening was defined as abdominal imaging (ultrasound, contrast-enhanced CT, or MRI) with or without serum alpha-fetoprotein (AFP) at least once every 12 months based on professional guidelines. RESULTS:One hundred fifty-six patients with cirrhosis were identified. The etiologies of cirrhosis were viral hepatitis (n = 65), alcohol (n = 40), non-alcoholic steatohepatitis (NASH) (n = 27), and non-viral, non-alcoholic, non-NASH cirrhosis (n = 24). Of the 156 patients, 51% received recommended screening for HCC. Patients with NASH cirrhosis received recommended screening significantly less (p = 0.016) than cirrhotics with viral hepatitis, alcoholic cirrhosis, or non-viral, non-alcoholic, non-NASH cirrhosis and were less likely to receive gastroenterology referral (p < 0.001). Additionally, 20 patients were diagnosed with cirrhosis incidentally during a surgical procedure. These patients were significantly less likely to receive recommended HCC screening than those diagnosed non-surgically (10.0 vs. 56.6%; p < 0.001). Screening was significantly more likely to occur in patients seen regularly by a gastrointestinal subspecialist (66.7 vs. 22.8%; p < 0.001). CONCLUSIONS:Patients with NASH cirrhosis and incidentally discovered cirrhosis have low rates of HCC screening and are referred less often to gastroenterologists. These data suggest a need for increased education about NASH cirrhosis and better systems of communication among general practitioners, surgeons, and gastroenterologists.
journal_name
Dig Dis Scijournal_title
Digestive diseases and sciencesauthors
Patwardhan V,Paul S,Corey KE,Mazhar SM,Richter JM,Thiim M,Chung RTdoi
10.1007/s10620-011-1836-2subject
Has Abstractpub_date
2011-11-01 00:00:00pages
3316-22issue
11eissn
0163-2116issn
1573-2568journal_volume
56pub_type
杂志文章abstract::Tramadol and morphine were compared for treatment of severe chronic pancreatitis pain and their interaction with gut motor function. Oral tramadol or morphine doses were titrated double-blinded and randomized for five days in 25 patients and pain, side effects, bowel function, orocecal and colonic transit, anal restin...
journal_title:Digestive diseases and sciences
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1023/a:1026607703352
更新日期:1999-06-01 00:00:00
abstract::The treatment options for palliating malignant gastroduodenal obstruction include open gastrojejunostomy (OGJ), laparoscopic gastrojejunostomy (LGJ), and endoscopic stenting (ES). The aim of this study was to compare the clinical outcomes and costs among ES, OGJ, and LGJ in patients who present with gastroduodenal obs...
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journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01347884
更新日期:1985-03-01 00:00:00
abstract::Recombinant fibroblast growth factors (FGFs) maintain the integrity of the gut epithelium and reduce mucosal injury in experimental inflammatory bowel disease (IBD). Chemically synthesized FGF mimetics could potentially extend the utility of FGFs by tailoring them for optimal bioactivity and oral administration, for e...
journal_title:Digestive diseases and sciences
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doi:10.1007/s10620-015-3967-3
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journal_title:Digestive diseases and sciences
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doi:10.1007/BF01317049
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abstract::The effect of insulin on the myoelectric activity of the small intestine was determined in conscious pigs. Animals were implanted with electrodes along the small intestine, a strain gage on the stomach and catheters in both saphenous arteries. Feeding modified the migrating myoelectric complex (MMC), a cyclic pattern ...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01307973
更新日期:1981-01-01 00:00:00
abstract::The bile acids in brown pigment stones and gallbladder bile were fractionated into free acids, glycine and taurine conjugates, and sulfates using diethylaminohydroxypropyl Sephadex LH-20 (DEAP-LH-20) column chromatography and were quantitated by gas chromatography. Twenty-eight cases of brown pigment stones were studi...
journal_title:Digestive diseases and sciences
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journal_title:Digestive diseases and sciences
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journal_title:Digestive diseases and sciences
pub_type: 杂志文章,评审
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journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-019-05686-4
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abstract::We present a case of collagenous colitis with evidence of terminal ileal involvement. The patient suffered from chronic watery diarrhea of three months' duration, and colonoscopy revealed a normal endoscopic appearance. Histologic examination of biopsies revealed a broad subepithelial band of collagen, with similar hi...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01297466
更新日期:1991-08-01 00:00:00
abstract::Sera from Japanese patients with chronic liver disease were tested for hepatitis B virus (HBV) markers and antibodies to hepatitis C virus (anti-HCV), and the results were correlated to the presence of hepatocellular carcinoma. In chronic non-A, non-B liver disease, anti-HCV prevalence was high both in patients with h...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01308344
更新日期:1992-01-01 00:00:00
abstract::The oral intake of food is important for the observed compensatory hyperplasia in the remnant small intestine after resection but the molecular events governing this response are not known. Peptides, of molecular weight 4500 and 1000 daltons, present in the the proximal intestine for 96 hr after resection and mitogeni...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01536635
更新日期:1988-01-01 00:00:00
abstract::We retrospectively evaluated clinical factors affecting long-term survival after treatment for hepatocellular carcinoma (HCC) to predict the reliability of the prognosis of patients with HCC. We analyzed 157 patients who received treatment for HCC. The prognostic index (PI) was evaluated using the Cox regression model...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-006-9137-x
更新日期:2007-09-01 00:00:00
abstract::Four patients with cold urticaria and six control subjects were studied. Gastric acid output was measured for 1 hr before and 1 hr after the immersion of both hands in ice cold water. The mean acid output fell in the control group by 16.3%. Acid output in the cold urticaria patients rose in each case following the col...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01315214
更新日期:1980-07-01 00:00:00
abstract::An important histologic feature of inflammatory bowel disease (IBD) is infiltration of the colonic mucosa with neutrophils. To investigate the nature of the chemotactic agents responsible for this infiltration, colonic mucosa from three normals and nine patients with inflammatory bowel disease (seven ulcerative coliti...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01296664
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journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1023/a:1026634721351
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journal_title:Digestive diseases and sciences
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journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-011-1640-z
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abstract::In a subset of patients with gastroesophageal reflux disease (GERD), symptoms persist in spite of proton pump inhibitor (PPI) therapy. Endoscopic gastroplication (EG) was reported to provide a novel therapeutic option in GERD. To evaluate symptomatic and objective outcome of EG in PPI refractory GERD, consecutive GERD...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-005-1610-4
更新日期:2005-02-01 00:00:00
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journal_title:Digestive diseases and sciences
pub_type: 杂志文章
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更新日期:1999-03-01 00:00:00
abstract::While transilluminating guinea pig gastric wall, we noticed foci of irregular compression of submucosal veins and arteries, featuring parallel bands across arteries, with complete cessation of blood flow, mucosal pallor, and shrinkage of the area. Other features demonstrated that this was not due to artifactual pressu...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/BF01296065
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:Little is known on practice patterns of endoscopists for the management of Barrett's esophagus (BE) over the last decade. AIMS:Our aim was to assess practice patterns of endoscopists for the diagnosis, surveillance and treatment of BE. METHODS:All members of the Italian Society of Digestive Endoscopy (SIED...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-020-06615-6
更新日期:2020-09-28 00:00:00
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journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-008-0376-x
更新日期:2009-03-01 00:00:00
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journal_title:Digestive diseases and sciences
pub_type: 杂志文章
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更新日期:2008-02-01 00:00:00
abstract::Current research in gene delivery to the liver is focused on the intravenous, intraarterial, intraportal, or intratumoral route. Another possible route for gene delivery is via the common bile duct through endoscopic retrograde cholangiopancreatography (ERCP). Whether bile and pancreatic juice have any effect on gene ...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
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更新日期:2000-02-01 00:00:00
abstract:AIMS:The purpose of this retrospective study was to assess clinical outcomes of endoscopic bougie dilation of esophageal strictures after radiation therapy for head and neck cancer, and to assess the risk factors which affect the treatment success. METHODS:Thirty-one patients with esophageal stricture due to radiation...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章
doi:10.1007/s10620-011-1875-8
更新日期:2012-02-01 00:00:00
abstract::We present a case of fatal, progressive hepatotoxicity in a patient treated with lamotrigine. After presenting with a rash and fever, she developed elevated liver function tests and clinical sequelae of hepatic failure. The subacute course of her progressive liver damage is documented in serial liver biopsies. While h...
journal_title:Digestive diseases and sciences
pub_type: 杂志文章,评审
doi:10.1023/a:1019627618972
更新日期:2002-09-01 00:00:00