Abstract：
:Recent data would limit indications for serum CEA measurement primarily to follow-up of resected colonic malignancy, yet physician attitude and usage patterns may lag far behind current findings. This discrepancy was investigated at our institution, where more than 1100 CEAs costing $71,000 are ordered each year. Of 45 physicians (all MDs ordering a CEA test during a preselected month), over 50% believed the test to be worthwhile in initial detection of colonic cancer, and 69% thought an elevated CEA to be an adequate reason to begin an aggressive workup to rule out cancer of the colon in a nonsmoking, previously healthy patient. Impressions of cost were less than or equal to $30 (50% of true cost) in nearly half of MDs and less than 20% of true cost in a tenth of MDs. Analysis of the medical record revealed that indications of questionable validity (initial detection of cancer together with follow-up of noncolonic malignancy) accounted for the majority of requested CEAs and included the attempted detection or monitoring of 12 different tumor types in addition to its use as a "general cancer screen." Patient benefit was realized in none in a random sample of 106 cases (beta = 0.11, power = 0.89 for an assumed benefit of 2%), while management was altered in only one patient as a direct result of the CEA value. It is important that we continue to inform and educate our colleagues about relatively expensive tests that have only limited and specific application.
journal_name
Dig Dis Scijournal_title
Digestive diseases and sciencesauthors
Vest SL,Roche JKdoi
10.1007/BF01296746subject
Has Abstractpub_date
1982-04-01 00:00:00pages
289-96issue
4eissn
0163-2116issn
1573-2568journal_volume
27pub_type
杂志文章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...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-006-9536-z
更新日期：2007-01-01 00:00:00
abstract：:The aim of the study was to assess the value of quantitative attenuation values (Hounsfield units) and of gallstone pattern by computerized tomography in predicting response to bile acid therapy. We carried out a prospective study in a multicenter setting on 90 consecutive outpatients with radiolucent gallstones. All ...
journal_title：Digestive diseases and sciences
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1007/BF02208664
更新日期：1995-09-01 00:00:00
abstract：:The effect of smoking on interdigestive gastrointestinal motility is little studied but may play a role in gastrointestinal morbidity. We studied gastroduodenal motility in 10 volunteers (five smokers and five nonsmokers) using a water-perfused pressure catheter. A pH probe was placed in the duodenal bulb. Baseline mo...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF02220449
更新日期：1995-12-01 00:00:00
abstract：BACKGROUND:Hepatic encephalopathy (HE) is a serious neuropsychiatric complication in both acute and chronic liver disease. AIMS:To establish the utility of a portable noninvasive method to measure ammonia in the breath of healthy subjects and patients with HE. METHODS:The study included 106 subjects: 44 women and 62 ...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-011-1858-9
更新日期：2012-01-01 00:00:00
abstract：:Biliary mucin was isolated from human hepatic bile, and its induced effects on the appearance time of cholesterol monohydrate crystals (nucleation time) and on the precipitation of calcium carbonate were studied in vitro to examine the possible significance of mucin for ductular gallstone formation. Mucin was isolated...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01295919
更新日期：1993-05-01 00:00:00
abstract：:The interaction of [35S]methionine with hepatic tRNA in normal, carcinogen-treated, and partially hepatectomized rats was studied. tRNA was preferentially labeled following [35S]methionine (1.6 mCi, 25 mg/kg body wt) administration by intraperitoneal injection. The extent of [35S]methionine-tRNA interaction was impair...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01297152
更新日期：1991-07-01 00:00:00
abstract：:The purpose of this study is to determine the long-term relapse rate and associated risk factors in HBeAg-positive chronic hepatitis B (CHB) patients who had maintained virologic response (VR) for 1 year after lamivudine (LMV) discontinuation. We enrolled 55 treatment-naive HBeAg-positive CHB patients who achieved and...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-008-0508-3
更新日期：2009-07-01 00:00:00
abstract：:Emodin inhibited expression of both transforming growth factor beta1 (TGFbeta1)- and phorbol ester (PMA)-induced tissue inhibitors of metalloproteinase-1 (TIMP-1) in an immortalized rat hepatic stellate cell line, HSC-T6, by Western blot and reverse transcription polymerase chain reaction. Reporter gene assays showed ...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-006-9321-z
更新日期：2007-01-01 00:00:00
abstract：BACKGROUND:It is not known whether transjugular intrahepatic porto-systemic shunt (TIPS) is safe in patients with advanced liver cirrhosis. The aim of our study was to evaluate the impact of TIPS on transplant-free survival in patients with liver cirrhosis and MELD score ≥15. METHODS:All adult patients who underwent T...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-016-4185-3
更新日期：2017-02-01 00:00:00
abstract：:A 68-year-old woman developed exfoliative dermatitis while taking cimetidine for gastritis. She had no history of previous drug reactions, allergies, or skin disorders and had taken no other medications for three months. Although cimetidine is a relatively safe drug, severe reactions such as exfoliative dermatitis can...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01312737
更新日期：1980-01-01 00:00:00
abstract：:Using northern blot analysis and immunohistochemistry, we assessed the expression and distribution of human epidermal growth factor receptor-1 (HER-1), HER-2, and HER-3 in pancreatic tissues obtained from patients with acute pancreatitis (AP). Overall, HER-1, HER-2, and HER-3 mRNA levels were similar in the normal pan...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF02208997
更新日期：1995-10-01 00:00:00
abstract：:In order to assess the effects of free or resin-bound bile acids on colonic topography, adult rats were surgically provided with an indwelling infusion catheter in the proximal cecum, which exited at the neck behind the head. Conscious, unrestrained rats were allowed chow ad libitum and were administered 1 ml of an in...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01296219
更新日期：1984-05-01 00:00:00
abstract：:The study was undertaken to examine regional differences in the concentrations of five regulatory peptides in the human colonic mucosa. Biopsies were obtained during routine colonoscopy from 33 patients whose colonic mucosa was macroscopically and histologically normal. Regulatory peptides were extracted, and measured...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01537267
更新日期：1989-08-01 00:00:00
abstract：:Autoimmune hepatitis has a variable clinical phenotype, and the absence of conventional autoantibodies does not preclude its diagnosis or need for treatment. The goals of this review are to describe the frequency and nature of autoantibody-negative autoimmune hepatitis, indicate its outcome after corticosteroid treatm...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章,评审
doi：10.1007/s10620-011-2017-z
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND:Safety-net hospitals are enriched in ethnic minorities and provide opportunities for high-impact hepatitis B virus (HBV) screening. AIM:We aim to evaluate the impact of a pilot program integrating HBV screening into outpatient endoscopy among urban safety-net populations. METHODS:From July 2015 to May 2017...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-017-4870-x
更新日期：2018-01-01 00:00:00
abstract：:We report a case of localized jejunal amyloidosis occurring in a 74-year-old man who experienced an episode of digestive bleeding while he was receiving oral anticoagulation. It illustrates a rare entity, characterized by an endoscopic aspect of polypoid, pseudotumoral formations. Histologically, submucosal connective...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1023/a:1005536901678
更新日期：2000-09-01 00:00:00
abstract：BACKGROUND:The endoscopic detection of esophageal cancer is suboptimal in both patients referred with dyspeptic symptoms and those enrolled in Barrett's surveillance programs. MCM5 expression in cells collected from gastric fluid may be correlated with the presence of dysplasia or adenocarcinoma. Analysis of this bioma...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-019-05607-5
更新日期：2019-10-01 00:00:00
abstract：:Our purpose is to describe seven cases of disseminated aseptic abscesses with regard to clinical, biological, radiological, and histological information, treatment, and outcome. Data were collected on seven Caucasian patients who had proven sterile deep abscesses diagnosed in French university hospitals. The onset of ...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1023/a:1018835228850
更新日期：1998-02-01 00:00:00
abstract：:Nos2 knockout mice were compared to wild-type mice for susceptibility to colitis in response to a diet supplemented with deoxycholate, a bile acid increased in the colon of individuals on a high-fat diet. Wild-type mice fed a fat-related diet, supplemented with 0.2% DOC, develop colonic inflammation associated with in...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-006-9608-0
更新日期：2007-03-01 00:00:00
abstract：:In a Caucasian woman with a history of ocular and pulmonary sarcoidosis, the occurrence of sclerosing peritonitis with exudative ascites but without any of the well-known causes of this syndrome prompts us to consider that sclerosing peritonitis is a manifestation of sarcoidosis. The dramatic improvement that occurred...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01299875
更新日期：1992-11-01 00:00:00
abstract：:Calcitonin gene-related peptide (CGRP) is thought to be involved in the regulation of gastric and mesenteric blood flow, in the control of gastric acid secretion and in the modulation of intestinal motility, yet the precise physiological roles of CGRP remain to be elucidated. To further examine the role(s) of CGRP in ...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-007-9848-7
更新日期：2008-01-01 00:00:00
abstract：:Dientamoeba fragilis is an intestinal protozoan parasite associated with gastrointestinal symptoms. This study was undertaken in a semicommunal group reported to have a high prevalence of this parasite. Stools were collected from 81 adult group members. Intestinal parasites were observed in stool specimens of 45 (56%)...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/BF01324950
更新日期：1983-04-01 00:00:00
abstract：:The objective of this study was to determine if HCV can be transmitted from patient to patient in psychiatric institutions and to determine possible routes of infection. We did a cross-sectional survey of 196 Japanese psychiatric patients tested for HCV and HBV markers and 400 age- and sex-matched controls. Anti-HCV w...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1023/a:1005472812403
更新日期：2000-02-01 00:00:00
abstract：:The gut microbiota is a vast ensemble of microorganisms inhabiting the mammalian gastrointestinal tract that can impact physiologic and pathologic processes. However, our understanding of the underlying mechanism for the dynamic interaction between host and gut microbiota is still in its infancy. The highly evolved ep...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章,评审
doi：10.1007/s10620-017-4538-6
更新日期：2017-05-01 00:00:00
abstract：BACKGROUND:Diagnosis of eosinophilic esophagitis (EoE) requires quantification of esophageal eosinophilia. AIMS:The aims of this study were to assess inter- and intraobserver reliability for measuring esophageal eosinophil counts and to validate a novel method of determining tissue eosinophil density using digitized h...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1007/s10620-009-1005-z
更新日期：2010-07-01 00:00:00
abstract：:The effect of chemical deafferentation, vagotomy (VGX), and gangliosympathectomy (GSX) on the density of fibers containing calcitonin gene-related peptide (CGRP) and substance P (Sub.P) in the rat gastric wall was studied. Chemical deafferentation by capsaicin abolished the density of CGRP-immunoreactive (IR) fibers, ...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1023/a:1018858208532
更新日期：1997-06-01 00:00:00
abstract：:H. pylori may colonize columnar-lined esophagus, although an etiologic role in esophageal adenocarcinoma is unproven. H. pylori can adhere to intestinal metaplasia in the stomach. This study was designed to examine if H. pylori adheres to specialized intestinal metaplasia in columnar-lined esophagus. Esophageal biopsi...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1023/a:1026628307895
更新日期：1999-06-01 00:00:00
abstract：:Since the publication of the last extensive review of hepatitis vaccines, use of inactivated hepatitis A vaccines has been extended to high-risk regions of the United States and specific patient groups, such as those with chronic liver disease, and use of the recombinant hepatitis B vaccines has been recommended for o...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章,评审
doi：10.1023/a:1015397807278
更新日期：2002-06-01 00:00:00
abstract：:For biotherapeutic agents, there is a lack of information on dose-response relationships and mechanism of action. The present study was designed to address these issues for Saccharomyces boulardii using the rat model of castor oil-induced diarrhea. A single dose of Saccharomyces boulardii at 12 x 10(10) CFU/kg of viab...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1023/a:1022801228938
更新日期：2003-04-01 00:00:00
abstract：:Although gastric cancer formation with H. pylori in Mongolian gerbils was recently reported, the same inoculation procedure did not result in cancer formation in other animals such as mice. Disturbed regulation of apoptosis and cell proliferation are known to link the multistep process of carcinogenesis. The present s...
journal_title：Digestive diseases and sciences
pub_type： 杂志文章
doi：10.1023/a:1013219621422
更新日期：2002-01-01 00:00:00
