Gastroenterology

Significance of exercise in nonalcoholic fatty liver disease in men: a community-based large cross-sectional study
Nonalcoholic fatty liver disease (NAFLD) is a risk factor for diabetes and cardiovascular disease that could progress to nonalcoholic steatohepatitis, cirrhosis, and liver failure. We aimed to assess the relationship between NAFLD and lifestyle habits. Using a community-based, cross-sectional design, the records of 11,094 Japanese subjects who had undergone at least 1 annual health checkup were...


First Detected Helicobacter pylori Infection in Infancy Modifies the Association Between Diarrheal Disease and Childhood Growth in Peru
In endemic settings, Helicobacter pylori infection can occur shortly after birth and may be associated with a reduction in childhood growth. This study investigated what factors promote earlier age of first H. pylori infection and evaluated the role of H. pylori infection in infancy (6–11 months) versus early childhood (12–23 months) on height. We included 183 children near birth from a...
Does Helicobacter pylori Protect against Eosinophilic Esophagitis in Children?
Helicobacter pylori infection and eosinophilic esophagitis (EoE) in children seem to have a reversed association with socioeconomic status (hygienic condition) and allergy conditions. While Hp infection (Hp) is highly associated with poor hygiene and/or poor socioeconomic status, but not with allergic conditions (asthma, rhinitis, etc.), EoE has the opposite epidemiological relationship (high a...


Fecal microbiota transplantation for management of Clostridium difficile infection
The widespread use of antibiotics has led Clostridium difficile infection (CDI) to become a common problem with pronounced medical and economic effects. The recurrence of CDI after treatment with standard antibiotics is becoming more common with the emergence of more resistant strains of C. difficile. As CDI is an antibiotic-associated disease, further treatment with antibiotic is best avoided....
A male patient with ferroportin disease B and a female patient with iron overload similar to ferroportin disease B
Reticuloendothelial iron overload is associated with secondary hemochromatosis including repeated transfusions and iron over-supplementation. Ferroportin disease B is a severe subtype of hereditary iron overload syndrome with an activated reticuloendothelial system. The iron exporter ferroportin may be insensitive to hepcidin 25 in this subtype. However, the interactions between the hepcidin–...


Diagnosis and management of intestinal Behçet’s disease
Behçet’s disease (BD) is a chronic relapsing disease with multiple organ system involvement characterized clinically by oral and genital aphthae, cutaneous lesions, and ophthalmological, neurological, and/or gastrointestinal manifestations. Little clinical evidence is available regarding the management of patients with intestinal BD, despite recognition that the presence of intestinal lesion...
Will There Be a Good General Surgeon When You Need One? (Part II) Solutions and Taking Back General Surgery
Multiple reports have cited the looming shortage of physicians over the next decades related to increasing demand, an aging of the population, and a stagnant level in the production of new physicians. General surgery shares in this problem, and the specialty is “stressed” by a declining workforce related to increasing specialization that leaves gaps in emergency, trauma, and rural surgical ...

Analysis of Microscopic Tumor Spread Patterns According to Gross Morphologies and Suggestions for Optimal Resection Margins in Bile Duct Cancer
Surgical resection is the only curative treatment for extrahepatic bile duct (EHBD) cancer, but guidelines for optimal resection margins have not yet been established. Therefore, the purpose of this study is to analyze the patterns of microscopic tumor spreads and their lengths according to gross morphology and to suggest optimal resection margins for EHBD cancer. A total of 79 patients with EH...
Effectiveness and Safety of Patient Activation Interventions for Adults with Type 2 Diabetes: Systematic Review, Meta-Analysis, and Meta-regression
Patient activation interventions (PAIs) engage patients in care by promoting increased knowledge, confidence, and/or skills for disease self-management. However, little is known about the impact of these interventions on a wide range of outcomes for adults with type 2 diabetes (DM2), or which of these interventions, if any, have the greatest impact on glycemic control. Electronic databases were...

Higher Practice Intensity Is Associated with Higher Quality of Care but More Avoidable Admissions for Medicare Beneficiaries
The relationship between practice intensity and the quality and outcomes of care has not been studied. To examine the relationship between primary care physicians’ costliness both for defined episodes of care and for defined patients and the quality and outcomes of care delivered to Medicare beneficiaries. Cross sectional analysis of physician survey data linked to Medicare claims. Physician ...
A Histologic Scoring System for Prognosis of Patients With Alcoholic Hepatitis
There is no histologic classification system to determine prognoses of patients with alcoholic hepatitis (AH). We identified histologic features associated with disease severity and created a histologic scoring system to predict short-term (90-day) mortality. We analyzed data from 121 patients admitted to the Liver Unit (Hospital Clinic, Barcelona, Spain) from January 2000 to January 2008 with ...

Effects of Tenofovir Disoproxil Fumarate in Hepatitis B e Antigen-Positive Patients With Normal Levels of Alanine Aminotransferase and High Levels of Hepatitis B Virus DNA
Little is known about the benefit of antiviral therapy for hepatitis B e antigen (HBeAg)−positive patients with high viral load and normal levels of alanine aminotransferase. We evaluated the effects of single and combination therapies in immune-tolerant patients with chronic hepatitis B. In a double-blind study, nucleos(t)ide-naïve patients with high levels of hepatitis B virus (HBV) DNA wh...
A New Laboratory-Based Algorithm to Predict Development of Hepatocellular Carcinoma in Patients With Hepatitis C and Cirrhosis
Serum levels of α-fetoprotein (AFP) are influenced not only by the presence of hepatocellular carcinoma (HCC), but also by the underlying severity and activity of liver disease, which is reflected by liver function tests. We constructed an AFP-based algorithm that included these factors to identify patients at risk for HCC, and tested its predictive ability in a large set of patients with cirr...
Risk of Colorectal Cancer for Carriers of Mutations in MUTYH, With and Without a Family History of Cancer
We studied 2332 individuals with monoallelic mutations in MUTYH among 9504 relatives of 264 colorectal cancer (CRC) cases with a MUTYH mutation. We estimated CRC risks through 70 years of age of 7.2% for male carriers of monoallelic mutations (95% confidence interval [CI], 4.6%–11.3%) and 5.6% for female carriers of monoallelic mutations (95% CI, 3.6%–8.8%), irrespective of family history....
Influence of Sucrose Ingestion on Brainstem and Hypothalamic Intrinsic Oscillations in Lean and Obese Women
The study of intrinsic fluctuations in the blood oxygen level-dependent signal of functional magnetic resonance imaging can provide insight into the effect of physiologic states on brain processes. In an effort to better understand the brain−gut communication induced by the absorption and metabolism of nutrients in healthy lean and obese individuals, we investigated whether ingestion of nutri...