Abstract：
GOALS:To estimate the hepatocellular carcinoma surveillance in the Medicaid cirrhotic population. BACKGROUND:Most studies predate 2005 American Association for the Study of Liver Diseases surveillance recommendations and do not examine the primary target population, cirrhotics. STUDY:From 2006 to 2007, we identified adults with at least 1 cirrhosis International Classification of Disease code and 15 months of continuous enrollment in North Carolina Medicaid, recording claims for abdominal ultrasound, computed tomography, magnetic resonance imaging, and α-fetoprotein testing. We used multivariable logistic regression to identify factors independently associated with imaging. RESULTS:A total of 5061 subjects were identified: mean age 54 years, 54% male patients, 35% African American, 56% white. Cirrhosis risk factors were alcohol (59%), hepatitis C (30%), hepatitis B (4%), others (18%), and unknown (24%). Only 26% underwent at least 1 imaging test. Just 12% of those not hospitalized or seen in an emergency department underwent any imaging test. Care in an academic facility, younger age, female sex, viral hepatitis, and Medicare coinsurance were positively associated with imaging. Twenty-one percent saw a gastroenterologist, which increased the odds of undergoing imaging (odds ratio, 2.81; 95% confidence interval, 2.32-3.41), whereas primary care visits did not (odds ratio, 0.94; 95% confidence interval, 0.76-1.16). CONCLUSIONS:Only a quarter of North Carolina Medicaid cirrhotics underwent abdominal imaging over a 15-month period, and many tests may have been conducted without surveillance intent. Gastroenterology visits nearly tripled the odds of imaging, but primary-care visits had no effect. Efforts to improve surveillance rates in cirrhotic patients should target primary care and increased access to subspecialty care.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Palmer LB,Kappelman MD,Sandler RS,Hayashi PHdoi
10.1097/MCG.0b013e318286fd97subject
Has Abstractpub_date
2013-09-01 00:00:00pages
713-8issue
8eissn
0192-0790issn
1539-2031journal_volume
47pub_type
杂志文章abstract：OBJECTIVES:To determine serum nitric oxide levels in pediatric patients with celiac disease and to compare them with the results obtained after 1 year of gluten-free diet. METHODS:We studied serum nitric oxide levels in 41 newly diagnosed patients with celiac disease. Serum levels of nitric oxide were reevaluated afte...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/01.mcg.0000177240.67215.da
更新日期：2005-10-01 00:00:00
abstract：GOALS:Assess neoplasia and polypectomy-related adverse event (AE) rates in gastric hyperplastic polyps (GHPs). BACKGROUND:GHPs carry a risk of neoplastic transformation. The rate of neoplastic transformation and the risk of polypectomy-related bleeding are unclear in the West, as data are derived from Asian or small s...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/MCG.0000000000001446
更新日期：2020-10-13 00:00:00
abstract：:Spontaneous umbilical fistula developed in two young women with Crohn's disease. This peculiar complication of Crohn's disease has been rarely reported. In view of the complete closure of the fistulas with medical treatment, we recommended conservative medical management, at least initially, in such patients. ...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章,评审
doi：10.1097/00004836-198904000-00016
更新日期：1989-04-01 00:00:00
abstract：BACKGROUND:Women with irritable bowel syndrome (IBS) frequently report chronic pelvic pain, however, it is still unanswered whether these are truly separate entities. IBS negatively impacts on quality of life, but the impact of IBS on sexual function is not clear. GOALS:We aimed to (1) describe the impact of IBS on se...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/MCG.0b013e3181d7a368
更新日期：2010-11-01 00:00:00
abstract：:Using an elevated serum amylase level to diagnose acute pancreatitis in an alcoholic patient with abdominal pain may not be appropriate, because hyperamylesemia is common in asymptomatic alcoholics without acute pancreatitis. To determine whether serum lipase also suffers from the same drawback, we undertook a prospec...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/00004836-199108000-00009
更新日期：1991-08-01 00:00:00
abstract：:We studied the levels of serum hepatitis C virus (HCV)-RNA, the HCV genotype before interferon therapy, and the kinetics of serum HCV-RNA at the initial stages of therapy to determine their utility in predicting the therapeutic efficacy of interferon in 44 patients with chronic hepatitis C infection. We also looked at...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/00004836-199710000-00009
更新日期：1997-10-01 00:00:00
abstract：:It is becoming increasingly recognized that purely clinical endpoints may not be sufficient in the treatment of patients with inflammatory bowel disease. As such, mucosal disease assessment has become a prominent component of the majority of recent clinical trials in Crohn's disease and ulcerative colitis. There is mo...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章,评审
doi：10.1097/MCG.0b013e3182732ff5
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:Mortality from ST elevation myocardial infarction (STEMI) is decreasing nationwide, but no report to date examined STEMI mortality among patients with cirrhosis. GOALS:Determine mortality rates and investigate possible disparities in cardiovascular interventions for patients with and without cirrhosis admit...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/MCG.0000000000000251
更新日期：2015-10-01 00:00:00
abstract：:We report a patient with classical features of amiodarone hepatotoxicity who died of progressive liver failure. Throughout the course of his illness, he had epigastric pain, nausea, vomiting, and persistent mild to moderate elevation of amylase and lipase in his serum and peritoneal fluid. Pancreatitis due to amiodaro...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/00004836-199002000-00018
更新日期：1990-02-01 00:00:00
abstract：:The human large intestine harbors a complex microbiota containing many hundreds of different bacterial species. Although structure/function relationships between different components of the microbiota are unclear, this complex multicellular entity plays an important role in maintaining homeostasis in the body. Many of...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章,评审
doi：10.1097/MCG.0b013e31822fecfe
更新日期：2011-11-01 00:00:00
abstract：BACKGROUND:Ascites due to cirrhosis may be difficult to distinguish from ascites due to heart failure by clinical features alone. More invasive testing is usually necessary, such as measurement of the hepatic venous pressure gradient, or paracentesis with measurement of the ascitic fluid total protein. AIM:The aim of ...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/MCG.0b013e318198113b
更新日期：2010-01-01 00:00:00
abstract：:Esophageal function was evaluated in 51 children less than 2 years of age with radiologic evidence of gastroesophageal reflux. Detection of an acid esophageal pH was a sensitive measure of gastroesophageal reflux. Lower esophageal sphincter pressures were greater in reflux patients with respiratory symptoms (18.0 +/- ...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/00004836-197906000-00004
更新日期：1979-06-01 00:00:00
abstract：:The advent of new diagnostic and therapeutic modalities for Helicobacter pylori allows any physician to offer curative antibiotic regimens to patients with peptic ulcer disease and gastritis. This article describes new management strategies and discusses the advantages of each. In the old strategy, endoscopy was perfo...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章,评审
doi：
更新日期：1995-01-01 00:00:00
abstract：:Lansoprazole is the first proton pump inhibitor developed in Japan. We studied the clinical efficacy of lansoprazole 30 mg q.d. on peptic ulcers and the subsequent relapse rates. The endoscopic healing rate of gastric ulcers (n = 86) after 8 weeks of treatment and duodenal ulcers (n = 52) after 6 weeks of treatment we...
journal_title：Journal of clinical gastroenterology
pub_type： 临床试验,杂志文章
doi：10.1097/00004836-199506002-00022
更新日期：1995-01-01 00:00:00
abstract：:In healthy volunteers, we studied the effect in intragastric administration of 100 ml 40% alcohol or isotonic saline on the ultrastructure of gastric oxyntic mucosa with emphasis on gastric mucosal microvasculature. We found that a single dose of 40% alcohol produces exfoliation of the surface epithelium, damage to th...
journal_title：Journal of clinical gastroenterology
pub_type： 临床试验,杂志文章
doi：
更新日期：1988-01-01 00:00:00
abstract：:Nasal continuous positive airway pressure (CPAP) reduces nocturnal gastroesophageal reflux (GER) in obstructive sleep apnea syndrome (OSAS) patients. The primary objectives of our investigation were to determine if CPAP could reduce reflux in non-OSAS patients and, if so, by what mechanism. Esophageal pH was monitored...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/00004836-199312000-00002
更新日期：1993-12-01 00:00:00
abstract：:Etiology of inflammatory bowel disease (IBD) is not yet completely understood, but it is hypothesized that a disruption of the immune tolerance to gut microbiota, due to several potential factors like an abnormal gut microbiota composition and activity, may lead to IBD occurrence. Manipulation of the intestinal microb...
journal_title：Journal of clinical gastroenterology
pub_type：
doi：10.1097/MCG.0000000000001095
更新日期：2018-11-01 00:00:00
abstract：BACKGROUND:Ultrasound-guided percutaneous acetic acid injection (PAI) therapy is effective for hepatocellular carcinoma (HCC). Posttreatment fever (>37.5 degrees C) may occur owing to acetic acid-induced tumor necrosis, but its incidence and clinical significance are not clear. METHODS:A total of 402 treatment session...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/00004836-200608000-00017
更新日期：2006-08-01 00:00:00
abstract：GOAL:The goal of this study was to evaluate the safety of propofol when used by gastroenterologists in patients who have an inadequate response to standard sedation (narcotics and benzodiazepines). BACKGROUND:Many patients fail to achieve adequate sedation from narcotics and benzodiazepines during colonoscopy. The adm...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/MCG.0000000000000445
更新日期：2016-09-01 00:00:00
abstract：:We conducted a retrospective 11-year survey to evaluate the post-treatment course in 285 patients with esophagogastric varices following administration of endoscopic injection sclerotherapy as an emergency, elective, or prophylactic procedure using freshly prepared 2% sodium tetradecyl sulfate not containing benzyl al...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/00004836-199601000-00017
更新日期：1996-01-01 00:00:00
abstract：:Thromboangiitis obliterans characteristically affects small- and medium-sized vessels of the limbs in young smokers. There is some controversy about the existence of visceral localizations of the disease. The case of a patient with a well-established diagnosis of thromboangiitis obliterans who presented with mesenteri...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章,评审
doi：10.1097/00004836-200101000-00020
更新日期：2001-01-01 00:00:00
abstract：:A 16-year-old boy was hospitalized because of abdominal pain, diarrhea, and weight loss. Serum immunoelectrophoresis showed an absence of IgA and diminished levels of IgM and IgG. Radiological examination of the upper gut was suggestive of lymphoid nodular hyperplasia, a diagnosis confirmed by endoscopy and intestinal...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/00004836-198006000-00012
更新日期：1980-06-01 00:00:00
abstract：GOALS:The authors aimed to characterize older adults' intentions for future surveillance colonoscopy, knowledge of polyps, and predictors of colonoscopy plans. BACKGROUND:Guidelines recommend that the decision to continue or stop surveillance colonoscopy in older adults with colon polyps be "individualized." Although ...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/MCG.0000000000001401
更新日期：2020-07-29 00:00:00
abstract：:We investigated whether autoimmune cholangitis (AC) has specific features that constitute an entity other than primary biliary cirrhosis (PBC). We compared clinical, laboratory, and liver biopsy features; response to treatment; and the follow-up of two groups of patients. The first group comprised seven patients with ...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/00004836-199610000-00007
更新日期：1996-10-01 00:00:00
abstract：:A 37-year-old man had fever, weight loss, malaise, right upper quadrant pain, lymphadenopathy, and a twofold elevation of serum alkaline phosphatase, transaminases, and gamma glutamyl transpeptidase. Granulomas were found on liver biopsy after 2 1/2 months of illness. Treatment with isoniazid and rifampin for 2 months...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/00004836-198906000-00021
更新日期：1989-06-01 00:00:00
abstract：GOALS:A clinical problem is posed by patients with symptoms suggestive of gluten sensitivity (diarrhea, weight loss, unresponsive iron-deficiency anemia, etc.); however, small intestinal biopsies reveal only minor abnormalities, such as lymphocytosis with or without crypt hyperplasia (Marsh I-II). Our aim was to assess...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/00004836-200301000-00006
更新日期：2003-01-01 00:00:00
abstract：:Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated, esophageal disease characterized by esophageal dysfunction and eosinophilic inflammation, manifested mainly as dysphagia and frequent food impaction. EoE is recognized into the spectrum of food allergy, but food sensitization studies used not to be ...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/MCG.0b013e3182432259
更新日期：2012-11-01 00:00:00
abstract：:The glycosphingolipid (GSL) compositions of the human, rabbit, and rat gastric mucosa were studied and compared. In neutral GSLs, although GalCer was the most abundant component in every tissue examined, species-specific differences were clearly observed in their composition. Acidic GSLs were composed of sulfatides an...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：
更新日期：1990-01-01 00:00:00
abstract：:Extrahepatic biliary atresia (EHBA), an inflammatory sclerosing cholangiopathy, is the leading indication for liver transplantation in children. The cause is still unknown, although possible infectious, genetic, and immunologic etiologies have received much recent focus. These theories are often dependent on each othe...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章,评审
doi：10.1097/MCG.0b013e3181646730
更新日期：2008-07-01 00:00:00
abstract：:We describe a patient with primary biliary cirrhosis associated with Graves' disease and discuss the possible autoimmune connections between the two disorders. ...
journal_title：Journal of clinical gastroenterology
pub_type： 杂志文章
doi：10.1097/00004836-198510000-00014
更新日期：1985-10-01 00:00:00
