Canadian Journal of Gastroenterology最新文献_第8页

Large pancreatic mass in a young woman. 年轻女性胰腺大肿块。

IF 2.7 4区医学

Canadian Journal of Gastroenterology Pub Date : 2013-04-01 DOI: 10.1155/2013/123204

Erin Rayner-Hartley, David F Schaeffer, Fergal Donnellan

{"title":"Large pancreatic mass in a young woman.","authors":"Erin Rayner-Hartley, David F Schaeffer, Fergal Donnellan","doi":"10.1155/2013/123204","DOIUrl":"https://doi.org/10.1155/2013/123204","url":null,"abstract":"A 26-year-old woman presented with several months’ history of abdominal discomfort, postprandial bloating and nausea. The patient was otherwise well and had no significant medical or family history. \u0000 \u0000A computed tomography scan revealed a heterogeneous cystic and solid mass 14 cm in size in the right upper quadrant. There was no vascular involvement or lymphadenopathy, or biliary or pancreatic duct dilation (Figure 1A). Subsequent endoscopic ultrasound revealed a homogenous solid mass occupying most of the pancreas parenchyma (Figure 1B). Fine-needle aspiration revealed abundant tumour cells, characterized by granular cytoplasm and round to oval nuclei with finely textured chromatin and an indistinct nucleolus (Figure 1C); in areas, the tumour cells surrounded delicate hyalinized fibrovascular cores (Figures 1C and and1D).1D). The tumour cells showed strong nuclear immunoreactivity for beta-catenin (Figure 1E). \u0000 \u0000 \u0000 \u0000Figure 1) \u0000 \u0000A Abdominal computed tomography scan demonstrating a mass 14 cm in size in the right upper quadrant. B Endoscopic ultrasound image demonstrating a homogenous solid mass 12.8 cm in size. C Cellular specimen, composed of neoplastic cells with round to oval ...","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/123204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31383881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gastrointestinal manifestations and management of anisakiasis. 异根线虫病的胃肠道表现和治疗。

IF 2.7 4区医学

Canadian Journal of Gastroenterology Pub Date : 2013-03-01 DOI: 10.1155/2013/427982

Lubna Madi, Massud Ali, Philippe Legace-Wiens, Donald R Duerksen

引用次数: 9

Serum aspartate aminotransferase levels and previous histopathological findings enable reduction of protocol liver biopsies after liver transplantation for hepatitis C. 血清天冬氨酸转氨酶水平和以前的组织病理学发现可以减少丙型肝炎肝移植后的肝活检。

IF 2.7 4区医学

Canadian Journal of Gastroenterology Pub Date : 2013-03-01 DOI: 10.1155/2013/904636

Tomohiro Tanaka, George Therapondos, Nazia Selzner, Eberhard L Renner, Leslie B Lilly

{"title":"Serum aspartate aminotransferase levels and previous histopathological findings enable reduction of protocol liver biopsies after liver transplantation for hepatitis C.","authors":"Tomohiro Tanaka, George Therapondos, Nazia Selzner, Eberhard L Renner, Leslie B Lilly","doi":"10.1155/2013/904636","DOIUrl":"https://doi.org/10.1155/2013/904636","url":null,"abstract":"Background: Hepatitis C virus (HCV) infection remains the leading indication for liver transplantation (LT) worldwide. Recurrent hepatitis C following LT is universal, and significant fibrosis (SF, Metavir fibrosis stage ≥2) apparent on protocol biopsy typically prompts antiviral therapy.Objective: To determine the optimal timing of protocol liver biopsies in this setting.Methods: A total of 151 patients who underwent LT related to HCV infection between July 2004 and December 2009 were analyzed retrospectively. Data regarding protocol liver biopsies at six, 12 and 24 months post-LT, conventional laboratory parameters and demographic information were obtained.Results: The 151 patients included in the present study had significantly lower serum aspartate aminotransferase (AST) levels than the four patients who progressed to receive antiviral treatment for SF before six months post-LT (P<0.001). AST level, but not alanine aminotransferase level, histological activity or fibrosis stage at the six-month biopsy was independently associated with the progression to SF at 12 months (P<0.05). However, AST level, histological activity and fibrosis stage at the 12-month biopsy emerged as independent parameters associated with progression to SF at 24 months (P<0.05).Conclusion: The protocol liver biopsy at six months could be eliminated, especially in patients who consistently exhibit low AST levels. Histological activity, the presence or absence of fibrosis, and AST values at the 12-month biopsy may lead to the decision to defer the protocol biopsy at 24 months or result in earlier introduction of antiviral therapy.","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/904636","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31325117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Environment and the inflammatory bowel diseases. 环境和炎症性肠病

IF 2.7 4区医学

Canadian Journal of Gastroenterology Pub Date : 2013-03-01 DOI: 10.1155/2013/102859

Alexandra Frolkis, Levinus A Dieleman, Herman W Barkema, Remo Panaccione, Subrata Ghosh, Richard N Fedorak, Karen Madsen, Gilaad G Kaplan

引用次数: 142

A health technology assessment of transient elastography in adult liver disease. 成人肝病瞬态弹性成像的健康技术评价。

IF 2.7 4区医学

Canadian Journal of Gastroenterology Pub Date : 2013-03-01 DOI: 10.1155/2013/684982

Rodney Steadman, Robert P Myers, Laura Leggett, Diane Lorenzetti, Tom Noseworthy, Sarah Rose, Lloyd Sutherland, Fiona Clement

{"title":"A health technology assessment of transient elastography in adult liver disease.","authors":"Rodney Steadman, Robert P Myers, Laura Leggett, Diane Lorenzetti, Tom Noseworthy, Sarah Rose, Lloyd Sutherland, Fiona Clement","doi":"10.1155/2013/684982","DOIUrl":"https://doi.org/10.1155/2013/684982","url":null,"abstract":"Background: An estimated one in 10 Canadians have some form of liver disease. The reference standard for staging and monitoring liver fibrosis is percutaneous liver biopsy--an invasive procedure associated with risks and complications. Transient elastography (TE) represents a noninvasive, ultrasound-based alternative.Objective: To assess the efficacy of TE compared with liver biopsy for fibrosis staging in adults with five common types of liver disease: hepatitis B, hepatitis C, nonalcoholic fatty liver disease, cholestatic liver disease and complications post-liver transplantation.Methods: A systematic review of published and grey literature from 2001 to June 2011 was conducted. Included were observational studies evaluating the accuracy of TE using liver biopsy as the comparator. An economic model was developed to estimate the cost per correct diagnosis gained with liver biopsy compared with TE. Identification of moderate fibrosis (stages 2 to 4) and cirrhosis (stage 4) were considered.Results: Fifty-seven studies were included in the review. The diagnostic accuracy of TE for the five clinical subgroups had sensitivities ranging from 0.67 to 0.92 and specificities ranging from 0.72 to 0.95. Liver biopsy was associated with an additional $1,427 to $7,030 per correct diagnosis gained compared with TE. The model was sensitive to the sensitivity and specificity of TE and the prevalence of fibrosis.Conclusions: TE is an accurate diagnostic method in patients with moderate fibrosis or cirrhosis. TE is less effective but less expensive than liver biopsy. Systemic implementation of TE should be considered for the noninvasive assessment of liver fibrosis.","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/684982","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31325119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 80

Low-dose acetylsalicylic acid use and the risk of upper gastrointestinal bleeding: a meta-analysis of randomized clinical trials and observational studies. 低剂量乙酰水杨酸的使用与上消化道出血风险：随机临床试验和观察性研究的荟萃分析。

IF 2.7 4区医学

Canadian Journal of Gastroenterology Pub Date : 2013-03-01 DOI: 10.1155/2013/596015

Vera E Valkhoff, Miriam C J M Sturkenboom, Catherine Hill, Sander Veldhuyzen van Zanten, Ernst J Kuipers

{"title":"Low-dose acetylsalicylic acid use and the risk of upper gastrointestinal bleeding: a meta-analysis of randomized clinical trials and observational studies.","authors":"Vera E Valkhoff, Miriam C J M Sturkenboom, Catherine Hill, Sander Veldhuyzen van Zanten, Ernst J Kuipers","doi":"10.1155/2013/596015","DOIUrl":"10.1155/2013/596015","url":null,"abstract":"Background: Low-dose acetylsalicylic acid (LDA, 75 mg/day to 325 mg/day) is recommended for primary and secondary prevention of cardiovascular events, but has been linked to an increased risk of upper gastrointestinal bleeding (UGIB).Objective: To analyze the magnitude of effect of LDA use on UGIB risk.Methods: The PubMed and Embase databases were searched for randomized controlled trials (RCTs) reporting UGIB rates in individuals receiving LDA, and observational studies of LDA use in patients with UGIB. Studies were pooled for analysis of UGIB rates.Results: Eighteen studies were included. Seven RCTs reported UGIB rates in individuals randomly assigned to receive LDA (n=22,901) or placebo (n=22,923). Ten case-control studies analyzed LDA use in patients with UGIB (n=10,816) and controls without UGIB (n=30,519); one cohort study reported 207 UGIB cases treated with LDA only. All studies found LDA use to be associated with an increased risk of UGIB. The mean number of extra UGIB cases associated with LDA use in the RCTs was 1.2 per 1000 patients per year (95% CI 0.7 to 1.8). The number needed to harm was 816 (95% CI 560 to 1500) for RCTs and 819 (95% CI 617 to 1119) for observational studies. Meta-analysis of RCT data showed that LDA use was associated with a 50% increase in UGIB risk (OR 1.5 [95% CI 1.2 to 1.8]). UGIB risk was most pronounced in observational studies (OR 3.1 [95% CI 2.5 to 3.7]).Conclusions: LDA use was associated with an increased risk of UGIB.","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3732153/pdf/cjg27159.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31325120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Monitoring hepatitis C infection in the liver allograft. 异体肝移植中丙型肝炎感染的监测。

IF 2.7 4区医学

Canadian Journal of Gastroenterology Pub Date : 2013-03-01 DOI: 10.1155/2013/297218

Bertus Eksteen

{"title":"Monitoring hepatitis C infection in the liver allograft.","authors":"Bertus Eksteen","doi":"10.1155/2013/297218","DOIUrl":"https://doi.org/10.1155/2013/297218","url":null,"abstract":"Chronic hepatitis C virus (HCV) infection-induced end-stage liver disease is the leading indication for liver transplantation and, in 2011, accounted for 1364 (23.5%) liver transplants performed in the United States. Treatment options for HCV are rapidly evolving, with realistic expectations of being able to cure the majority of patients in the very near future before the need for for transplantation arises. Until such time, the status quo we are faced with is a large cohort of HCV cirrhosis patients who will require salvage with liver transplantation. The difficulty with hepatitis C post-transplantation is that reinfection of the allograft is virtually universal. Reinfection occurs with a wide range of clinical presentations ranging from the most severe form, fibrosing cholestatic hepatitis, which occurs very early after transplantation and invariably leads to early graft failure and a possible need for retransplantation or death, to a milder but still aggressive course in the majority of patients leading to bridging fibrosis and cirrhosis. The rate at which this develops is approximately 30% to 50% at five years without antiviral treatment (1). An essential element of managing post-transplant hepatitis C is to detect individuals who are at risk of progression at an early stage, defined by most studies as a Metavir score ≥2, and commence antiviral treatment (1).","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/297218","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31325116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sweet syndrome secondary to inflammatory bowel disease. 炎症性肠病继发的甜综合征。

IF 2.7 4区医学

Canadian Journal of Gastroenterology Pub Date : 2013-03-01 DOI: 10.1155/2013/848316

Malcolm M Wells, William Stecho, Bret Wehrli, Nitin Khanna

{"title":"Sweet syndrome secondary to inflammatory bowel disease.","authors":"Malcolm M Wells, William Stecho, Bret Wehrli, Nitin Khanna","doi":"10.1155/2013/848316","DOIUrl":"https://doi.org/10.1155/2013/848316","url":null,"abstract":"1Department of Gastroenterology; 2Department of Pathology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario Correspondence: Dr Malcolm M Wells, Schulich School of Medicine, University of Western Ontario, Room M106, Medical Science Building, London, Ontario N6A 5C1. Telephone 519-685-8500, e-mail malcolm.wells@gmail.com Received for publication September 20, 2012. Accepted October 2, 2012 CASE PRESENTATION A 64-year-old man presented to hospital with a three-month history of progressively worsening mucousy bloody diarrhea, polyarthritis and a rash covering his lateral malleolus. His history was significant for previous quadriceps tendon rupture and supraventricular tachycardia. His only medication was a short course of prednisone initiated shortly before his hospitalization. He was a nonsmoker and nondrinker, with no significant family history. Physical examination was significant for a fever of 38.2°C as well as a warm swollen left knee, ankle and foot. A bullous lesion 5 cm in size was present on the medial aspect of the left malleolus (Figure 1), with an erythematous base and draining serosanginous fluid. He exhibited multiple oral ulcers. The remainder of the examination was noncontributory. Laboratory investigations revealed neutrophilia (14.5×109/L) and a normocytic anemia (1×105 g/L). Stool was negative for ova and parasites, and cell culture was negative for Clostridium difficile.","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/848316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31325114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Disease burden of chronic hepatitis B among immigrants in Canada. 加拿大移民慢性乙型肝炎的疾病负担

IF 2.7 4区医学

Canadian Journal of Gastroenterology Pub Date : 2013-03-01 DOI: 10.1155/2013/924640

William W L Wong, Gloria Woo, E Jenny Heathcote, Murray Krahn

{"title":"Disease burden of chronic hepatitis B among immigrants in Canada.","authors":"William W L Wong, Gloria Woo, E Jenny Heathcote, Murray Krahn","doi":"10.1155/2013/924640","DOIUrl":"https://doi.org/10.1155/2013/924640","url":null,"abstract":"Background: The prevalence of chronic hepatitis B (CHB) infection among immigrants to North America ranges from 2% to 15%, 40% of whom develop advanced liver disease. Screening for hepatitis B surface antigen is not recommended for immigrants.Objective: To estimate the disease burden of CHB among immigrants in Canada using Markov cohort models comparing a cohort of immigrants with CHB versus a control cohort of immigrants without CHB.Methods: Markov cohort models were used to estimate life years, quality-adjusted life years and lifetime direct medical costs (adjusted to 2008 Canadian dollars) for a cohort of immigrants with CHB living in Canada in 2006, and an age-matched control cohort of immigrants without CHB living in Canada in 2006. Parameter values were derived from the published literature.Results: At the baseline estimate, the model suggested that the cohort of immigrants with CHB lost an average of 4.6 life years (corresponding to 1.5 quality-adjusted life years), had an increased average of $24,249 for lifetime direct medical costs, and had a higher lifetime risk for decompensated cirrhosis (12%), hepatocellular carcinoma (16%) and need for liver transplant (5%) when compared with the control cohort.Discussion: Results of the present study showed that the socio-economic burden of CHB among immigrants living in Canada is substantial. Governments and health systems need to develop policies that promote early recognition of CHB and raise public awareness regarding hepatitis B to extend the lives of infected immigrants.","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/924640","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31325118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 24

The endoscopy Global Rating Scale-Canada: development and implementation of a quality improvement tool. 加拿大内镜检查全球评分量表：质量改进工具的开发与实施。

IF 2.7 4区医学

Canadian Journal of Gastroenterology Pub Date : 2013-02-01 DOI: 10.1155/2013/165804

Donald MacIntosh, Catherine Dubé, Roger Hollingworth, Sander Veldhuyzen van Zanten, Sandra Daniels, George Ghattas

{"title":"The endoscopy Global Rating Scale-Canada: development and implementation of a quality improvement tool.","authors":"Donald MacIntosh, Catherine Dubé, Roger Hollingworth, Sander Veldhuyzen van Zanten, Sandra Daniels, George Ghattas","doi":"10.1155/2013/165804","DOIUrl":"10.1155/2013/165804","url":null,"abstract":"Background: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer.Objective: To adapt the United Kingdom Global Rating Scale (UK-GRS) to develop a web-based and patient-centred tool to assess and improve the quality of endoscopy services provided.Methods: Based on feedback from 22 sites across Canada that completed the UK endoscopy GRS, and integrating results of the Canadian consensus on safety and quality indicators in endoscopy and other Canadian consensus reports, a working group of endoscopists experienced with the GRS developed the GRS-Canada (GRS-C).Results: The GRS-C mirrors the two dimensions (clinical quality and quality of the patient experience) and 12 patient-centred items of the UK-GRS, but was modified to apply to Canadian health care infrastructure, language and current practice. Each item is assessed by a yes⁄no response to eight to 12 statements that are divided into levels graded D (basic) through A (advanced). A core team consisting of a booking clerk, charge nurse and the physician responsible for the unit is recommended to complete the GRS-C twice yearly.Conclusion: The GRS-C is intended to improve endoscopic services in Canada by providing endoscopy units with a straightforward process to review the quality of the service they provide.","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731117/pdf/cjg27074.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31291590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0