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Sample records for gastroenterology 46th annual

  1. Try It Again, Uncle Sam: The 46th Annual PDK/Gallup Poll of the Public's Attitudes toward the Public Schools. [Part I

    ERIC Educational Resources Information Center

    Bushaw, William J.; Calderon, Valerie J.

    2014-01-01

    The 46th Annual PDK/Gallup Poll of the Public's Attitudes toward the Public Schools reveals that Americans say they know a lot more this year about the Common Core State Standards than they indicated a year ago, and they like it a lot less. Americans also say local school boards should have the greatest influence in deciding what is taught in the…

  2. Americans Put Teacher Quality on Center Stage: The 46th Annual PDK/Gallup Poll of the Public's Attitudes toward the Public Schools. Part II

    ERIC Educational Resources Information Center

    Bushaw, William J.; Calderon, Valerie J.

    2014-01-01

    In this, the second installment of a two-part report of the 46th annual PDK/Gallup Poll of the Public's Attitudes Toward the Public Schools, the report unveils what Americans are thinking about public schools--in particular their views of teachers and the classrooms where they work. Some findings were surprising, others were not. For example,…

  3. Americans Put Teacher Quality on Center Stage: The 46th Annual PDK/Gallup Poll of the Public's Attitudes toward the Public Schools. Part II

    ERIC Educational Resources Information Center

    Bushaw, William J.; Calderon, Valerie J.

    2014-01-01

    In this, the second installment of a two-part report of the 46th annual PDK/Gallup Poll of the Public's Attitudes Toward the Public Schools, the report unveils what Americans are thinking about public schools--in particular their views of teachers and the classrooms where they work. Some findings were surprising, others were not. For example,…

  4. The 11th Annual International Congress of Pediatric Hepatology, Gastroenterology and Nutrition.

    PubMed

    A-Kader, H Hesham

    2009-02-01

    The 11th Annual International Congress of Pediatric Hepatology, Gastroenterology and Nutrition, hosted by the Egyptian Pediatric Association in collaboration with the International Association for the Study of The Liver, provided a comprehensive review of different subjects related to pediatric hepatology, gastroenterology and nutrition. The meeting was chaired by Professor Mortada El-Shabrawi from Cairo University Children's Hospital and Professor Talal Abdel Aziz Farrag from the Military Medical Academy, Cairo, Egypt.

  5. A report from the 46th Annual Meeting of the European Association for the Study of Diabetes (September 20-24, 2010 - Stockholm, Sweden).

    PubMed

    Rabasseda, X

    2011-01-01

    Old and modern architecture go hand in hand along the many waterfronts in Stockholm, just as old (established) and new (investigational) drugs for treating diabetes shared time and space at the oral and poster sessions during the 2010 European Association for the Study of Diabetes (EASD) meeting in Älfsjö. Old and new drugs shared the spotlight at the meeting, the main declared objective of which was to promote excellence in diabetes care through research and education. Although it is important to attend the EASD meeting in order to obtain information on what's new firsthand-new drugs, new indications, new treatment modalities... as well as news on negative aspects and limitations of drug therapy-not all healthcare professionals can attend so many annual meetings, and those who can, cannot attend many of the parallel sessions, and thus alternative sources of information are needed. Indeed, education has a major role in the management and prevention of diabetes, obesity and related disorders, all of which carry a high cardiovascular risk, but if educating patients and the general population is essential, so is informing healthcare professionals about new therapies and new findings related with the management of diabetes. In line with the previously stated attendance limitations and alternative sources of information-or education-this is the scope of the following report, which complements other information on subjects discussed during the EASD meeting in Stockholm available online through other channels.

  6. Recent progress and diverse effects in developmental immunotoxicology: overview of a symposium at the 46th Annual SOT Meeting, Charlotte, NC.

    PubMed

    Rooney, Andrew A; Yang, Yung; Makris, Susan L

    2008-10-01

    It has long been known that the developing immune system is more sensitive and susceptible than the adult immune system to some drugs and environmental contaminants. However, notable advances have been made in the database of studies supporting developmental immunotoxicity (DIT) over the past 5 years. There is considerable evidence that responses of the immune system can be quantitatively or qualitatively different from normal adult responses when xenobiotic exposure occurs during critical periods of immune system development. Qualitative differences of DIT relative to adult exposures include examples of more persistent effects, a latency of effects, and immune dysfunction that is fundamentally different than effects observed when adults are exposed. A symposium was presented at the Society of Toxicology annual meeting to provide an update on advances in the maturing field of developmental immunotoxicology and to facilitate discussion on the range of DIT and later life effects following developmental exposure. In particular, presentations focused on implications of neuroendocrine cross-talk for DIT, the association between developmental air pollutant exposure and asthma, and recent evidence that developmental exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin may increase the risk of autoimmune responses. Several important concepts relative to DIT assessment were illustrated, i.e., (1) Screening for immunosuppression alone is not sufficient to identify all potential immunotoxic effects; (2) DIT cannot be reliably predicted from studies that only utilize adult exposures; (3) Functional testing protocols are preferred in the assessment of DIT; (4) Gender-related differences should be routinely assessed; (5) Latency (i.e., later-life adverse outcomes resulting from developmental exposures) is an important consideration that cannot be detected in adult exposure studies; and, (6) There is increasing support for DIT testing protocols with continuous exposure throughout

  7. The Fate of Abstracts Presented at the 2013 and 2014 Annual Meetings of the Romanian Society of Gastroenterology and Hepatology.

    PubMed

    Trifan, Anca; Chihaia, Catalin-Alexandru; Tanase, Oana; Lungu, Cristina-Maria; Stanciu, Carol

    2016-12-01

    Oral and poster presentations at annual national meetings of the Romanian Society of Gastroenterology and Hepatology (RSGH) provide a forum for education, communication and discussion of new research. However, for the wide-spread dissemination of the new research work, each presentation should be subsequently published as a full-text article in peer-reviewed, indexed journals. to evaluate the publication rate of full-text articles in peer-reviewed journals after being first presented as abstracts at two consecutive RSGH annual meetings. A retrospective review of all abstracts presented at the annual meetings in 2013 and 2014 was performed. PubMed and Google Scholar were searched using abstract titles, first author's name and affiliation, and key words from the title to identify whether an abstract resulted in a peer-reviewed publication. Abstracts published in full-text were subsequently assessed for study type, study center, topics, publication year, journals and their impact factors (IFs). We chose the 2013 and 2014 meetings to ensure a minimum two-year follow-up period since the last meeting for the publication as full-length articles. A total of 562 abstracts were presented (275 in 2013, 287 in 2014). There were 150 oral presentations (93 in 2013, 57 in 2014) and 412 poster presentations (182 in 2013, 230 in 2014). Fifty seven of them (10.1%) were published as full-text articles, among them 26 (17.3%) after oral presentations and 31 (7.5%) after poster presentations (P=0.001). University affiliation and original research work were most likely to be published. The average IFs of the journals which published the articles were 2.42 in 2013 and 1.87 in 2014. The publication rate for the annual RSGH meetings abstracts as full-text articles in peer-reviewed journals is very low compared to the analyses performed in gastroenterology or other medical specialities from other countries. It is not clear yet what are the factors responsible for the failure of publication.

  8. Raptor gastroenterology.

    PubMed

    Murray, Maureen

    2014-05-01

    Free-living raptors are frequently presented to wildlife rehabilitation centers. Conditions affecting the gastrointestinal tract can be the primary reason for presentation. The gastrointestinal tract can also be affected secondary to debilitation from other injuries or from the stress of the rehabilitation process. A thorough understanding of the anatomy, physiology, and natural history of these species is crucial to successful treatment and rehabilitation. This article addresses raptor gastroenterology with an emphasis on conditions affecting free-living birds.

  9. 46th Annual Gun and Missile Systems Conference and Exhibition

    DTIC Science & Technology

    2011-09-01

    no genotoxic effects . • In “28 Days Inhalation Toxicity Study“ there were found typical symptoms for phosphoric acid / phosphorus oxide with 1 mg/m...Miller, GD-ATP – MODELING & SIMULATION II: TEST METHODS 11838 - A Method for Assessing the Effects of Overpressure from Small/Medium Caliber Weapons...CONCURRENT SESSIONS MONROE – ENERGETICS I 11822 - Novel ARDEC Igniters for Gun Systems, Dr. Eugene Rozumov, U.S. Army ARDEC 11787 - The Effects of Igniter

  10. North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

    MedlinePlus

    North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Skip to Navigation NASPGHAN Annual Meeting and Postgraduate ... transition well. Moreover, Doc4me provides information about medications, nutrition and living with IBD. Please help us promote ...

  11. Alternative bibliometrics from impact factor improved the esteem of a journal in a 2-year-ahead annual-citation calculation: multivariate analysis of gastroenterology and hepatology journals.

    PubMed

    Roldan-Valadez, Ernesto; Rios, Camilo

    2015-02-01

    A deeper understanding of supplementary bibliometrics beyond the impact factor might provide researchers with a better understanding of the citation process. This study presents a multivariate analysis of gastroenterology and hepatology journals to evaluate the predictive ability of seven bibliometrics in the Web of Science to calculate total cites over a 2-year period. Coincidentally, bibliometrics appearing during 2008, 2009, and 2010, with their corresponding cites in 2010, 2011, and 2012, were recorded from the Journal Citation Reports Science Edition. A linear mixed-effects design using random slopes and intercepts was performed on 51 out of 74 journals in the Gastroenterology and Hepatology category. There was a significant global effect size (R(2) = 0.992; P < 0.001), which yielded a total variance of 99.2%. The strongest predictors in the model were the Eigenfactor Score and Cited Half-life (P < 0.001), followed by the Number of Articles (P = 0.011) and the Immediacy Index (P = 0.021). The impact factor was not a significant predictor. The Eigenfactor Score and Cited Half-life predictors might be the new standards to assess the influence and importance of scientific journals; this approach may help researchers select journals in which to publish their work.

  12. [Gastroenterology towards 2020].

    PubMed

    Koch, Maurizio

    2016-06-01

    Research in gastroenterology and hepatology is booming. The spectrum of digestive diseases is very extensive, and growing. This issue of the journal focuses on the near future of gastreonterology, and announces what changes should we expect between now and 2020. The next number will be devoted to changes in hepatology.

  13. [Across gastroenterologic lexicology].

    PubMed

    Jorge, F C

    1983-01-01

    Based on the actual misuse of biomedical words in the literature, the author tries, through some illustrative examples of gastroenterologic lexicology, to establish criteria to a better use of medical terms considering among other factors, its ethymological basis, definition, and polyglottic equivalents in different idioms.

  14. [Virtual room of gastroenterology].

    PubMed

    Spinelli, Osvaldo Mateo; Fittipaldi, Mónica Elsa; Henderson, Eduardo; Krabshuis, Justus Hendrik

    2010-12-01

    The amount of published information and its continuing growth can no longer be managed by an individual searcher. One of today's great challenges for the academic researcher and clinician is to find a relevant scientific article using bibliographic search strategies. We aimed to design and build a Virtual Room of Gastroenterology (VRG) generating real-time automated search strategies and producing bibliographic and full text search results. These results update and complement with the latest evidence the Clinical Guideline Program of the World Gastroenterology Organisation. The HTML driven interface provides a series of pre-formulated MeSH based search strategies for each Aula. For each topic between 10 and 20 specific terms, qualifiers and subheadings are identified. The functionality of the VRG is based on the PubMed's characteristic that allows a search strategy to be captured as a web address. The VRG is available in Spanish and English, and the access is free. There are 28 rooms currently available. All together these rooms provide an advanced bibliographic access using more than 900 pre-programmed MeSH driven strategies. In a further very recent development some of the topics of VRG now allow cascade based searches. These searches look at resource sensitive options and possible ethnic difference per topic. The VRG allows significant reductions in time required to design and carry out complex bibliographic searches in the areas of gastroenterology, hepatology and endoscopy. The system updates automatically in real-time thus ensuring the currency of the results.

  15. Complementary and Integrative Gastroenterology.

    PubMed

    Korzenik, Joshua; Koch, Anna K; Langhorst, Jost

    2017-09-01

    Complementary and integrative medicine is developing within gastroenterology, expanding options particularly for inflammatory bowel disease, irritable bowel syndrome, and reflux esophagitis. This article encompasses new developments in complementary integrative medicine with an emphasis on herbal therapies. Studies of potential therapies have been advancing with increasing sophistication. The best studied with the most promising results in ulcerative colitis is the use of curcumin both for the induction and maintenance of remission. Other polyphenols, such as resveratrol and epigallocatechin-3-gallate, also have supportive data for ulcerative colitis. Mind-body approaches have been applied in these diseases with positive data, particularly for irritable bowel syndrome. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Evolution of gastroenterology training

    PubMed Central

    Telleman, Hanna; Burger, Trevlyn Felicity; Mulder, Chris Jacob Johan

    2009-01-01

    There have been rapid developments in gastroenterology (GE) over the last decade. Up until the late 1980s, GE-training was incorporated in Internal Medicine training. The introduction of endoscopy has necessitated the need for additional training. Around the world different national boards have developed their own curricula which will be discussed in this paper. Emphasis will be placed on the curriculum recently introduced in The Netherlands. The internal medicine component has become a two-year requirement (Common Trunk) and the duration of training in GE has been extended to four years. Because of the growing complexity of GE, there are now four subspecialties: Interventional Endoscopy, Neuromotility, Oncology and Hepatology that trainees can choose from. These subspecialties each have predefined specific requirements. The World Gastroenterology Organization has drawn up a standard curriculum which can be of help to the boards in different countries. The curriculum emphasizes the knowledge and skill components. The curriculum also defines the training recommendations, the requirements of training facilities and competence evaluation of fellows and facilities, while less is said about research, finance and the number of gastroenterologists required. In the coming decades the curriculum will need to be revised continuously. Personalization of the curriculum will be the next challenge for the years to come. PMID:19370773

  17. Effective teamworking in gastroenterology

    PubMed Central

    Haycock, Adam; Matharoo, Manmeet K; Thomas-Gibson, Siwan

    2012-01-01

    The majority of healthcare provision within the NHS is delivered by teams, but most attempts at improving team functioning are limited to promoting working relationships within the team. This contrasts with other high risk industries, where formalised team training is recognised to be of paramount importance in reducing error. Some medical specialities have adapted such training methodologies with the aim of improving productivity and clinical outcomes. There are many teams within gastroenterology that could benefit from such attention. Formal analysis of team objectives and identification of essential task sequences can allow redesign of team organisation and enable structured training to strengthen team cohesion, enhance critical team skills and improve clinical outcomes. The challenge is to change teams of experts into expert teams. PMID:28839641

  18. Therapeutic endoscopy in gastroenterology.

    PubMed

    Celiński, K; Cichoz-Lach, H

    2007-08-01

    The role of therapeutic endoscopy in current gastroenterology is very important. Therapuetic endoscopy is useful in treatment of gastrointestinal bleeding. Endoscopic control of gastrointestinal bleeding includes the following procedures of haemostasis techniques: photocoagulation, electrocoagulation, thermocoagulation and injection method. Owing to these procedures mortality has significantly decreased. Endoscopic hemostasis eliminates the risk of surgery, is less expensive and better tolerated by patients. Colonoscopic polypectomy is a widely used technique. By removal of polyps the incidence of colon cancer can be decreased. The "hot biopsy" forceps can be used to excise polyps of up to 6 mm. Larger polyps can be removed safely by snare electrocautery and retrieved for histologic study. Endoscopic retrograde cholangiopancreatography has a therapeutic application designed to cut the sphincter of Oddi fibers of the distal common bile duct, what is indicated currently in choledocholithiasis and papillary stenosis with ascending cholangitis, acute gallstone pancreatitis. Endoscopic sphincterotomy in now an established procedure that is indicated in patients with common bile duct calculi. Endoscopic decompression of the biliary tree - dilatation benign structures of the biliary tree with baloon catheters and placement an internal endoprothesis allows the nonoperative decompression and significant palliation for patients with obstructing tumors.

  19. 46th Annual Gun and Missile Systems Conference and Exhibition. Volume 2. Wednesday

    DTIC Science & Technology

    2011-09-01

    12000 rounds of ammunition and > 22000 weapon cycles)  Ammunition Sequential Trials Programme  Ammunition Non Sequential Trials  Cannon...266-4741 Next Generation Machining & Modeling Technology Presentation NDIA Guns & Missiles 2011 ISO 9001 Certified FS15149 Next...of design, fabrication, acquisition capabilities ISO 9001 Certified FS15149 Next Generation Machining & Modeling Technology • Facts

  20. 46th Annual Targets, UAVs and Range Operations Symposium and Exhibition

    DTIC Science & Technology

    2008-10-10

    Segment Team Spring/Summer ’08 Comm Link Hardware is being integrated with a Test Article Network Installed in Test Pilot School H-60 Fall ’08 First...Director, Air Warfare, DOT&E SESSION I: RANGES AND RANGE OPERATIONS: Integrated Network Telemetry (iNET): Mr. Thomas Grace, Chief Engineer, Test Article , ATL...inet)  mr. thomas grace, Chief engineer, test article , atL-trmC, naval air warfare Center 9:20 am - 9:40 am gulf range drone Control system

  1. 48th ICAAC/46th IDSA Annual Meeting: a pediatric perspective.

    PubMed

    Ulloa-Gutierrez, Rolando; Soriano-Fallas, Alejandra; Camacho-Badilla, Kattia; Arguedas, Adriano

    2009-02-01

    A combined meeting of the American Society of Microbiology and the Infectious Diseases Society of America was held recently in Washington, DC, USA, which gathered worldwide experts in the fields of infectious diseases, microbiology and the pharmaceutical industry, among others. Owing to its huge attendance and being among the largest conferences in the world during the year for infectious disease specialists, we focus only in the most relevant issues related to pediatric vaccines. Among others, we mention dengue, rotavirus, HIV, influenza virus, Streptococcus pneumoniae, Neisseria meningitidis, pertussis, measles and mumps. The case with mumps and measles illustrates the negative impact that vaccine refusal, fears and low coverage rates have on the resurgence of outbreaks produced by these two viruses. However, even with full vaccination schedules, other factors, such as waning immunity, influence the resurgence of these old diseases: pertussis, measles and mumps. This illustrates the importance of continuous surveillance in the epidemiology of vaccine-preventable diseases once a vaccine is licensed and introduced in a given population.

  2. 46th Annual Gun and Missile Systems Conference and Exhibition. Volume 3 - Thursday

    DTIC Science & Technology

    2011-09-01

    personnel. A broad range of topics related to design and development of technology and training, and development of people in the gun and missile...demonstrations • Path forward - mature 81mm air drop munition to a fully integrated tactical configuration and conduct live fire flight demonstrations...S40mm x 218 APFSDS-T – S40mm x 165 HEAB-T • Live fire demonstrations at High Rate Bursts (HRB) out of the MK44 mounted in a Bradley Fighting

  3. AHS, Annual Forum, 46th, Washington, DC, May 21-23, 1990, Proceedings. Volumes 1 2

    SciTech Connect

    Not Available

    1990-01-01

    The present conference on helicopter technologies discusses the application of chaos methods to higher harmonic control of rotors, a FEM model reduction application to rotorcraft structure applications, the numerical simulation of powered-lift flows, V/STOL concepts for special applications, advanced rotorcraft transmissions, advanced helicopter avionics, three-dimensional shock-fitting for transonic rotor acoustics, a model-based procedure for low vibration rotor design generation, and an integrated aerodynamic load/dynamic approach to optimum rotor blade design. Also discussed are numerical optimization for tiltrotor blade aerodynamic design, aging U.S. Army aircraft, mission/task analysis for weapon system cost and risk reduction, night vision goggle compatibility with color displays in Army aircraft, the structural evaluation of a composite fuselage structure, composite actuators for airborne systems, wake surveys of advanced rotor platforms, safe strength/damage-tolerance assessment, cargo rotorcraft in future Army operations, tests of the V-22 flight control system, heliport/vertiport development, advanced surface-hardening technologies, and main rotorblade bonding automation.

  4. CECSelected Convention Papers; Annual International Convention (46th, New York City, April 14-20, 1968.)

    ERIC Educational Resources Information Center

    Council for Exceptional Children, Arlington, VA.

    A collection of selected convention papers is presented on the following topics: the gifted child, children with behavioral disorders, the visually handicapped, programs in special education, the homebound and hospitalized, children with learning disabilities, international aspects of special education, general articles, administration programs,…

  5. [Choosing wisely recommendations in gastroenterology].

    PubMed

    Koop, H; Lynen Jansen, P; Zeuzem, S

    2017-06-01

    The Choosing wisely initiative of the German Society of Internal Medicine addresses procedures which are inadequately implemented (deficits in patient care) as well as those which are performed too often but without proven benefits for patients (misuse or overuse of health services). Based on their guidelines, The German Society of Gastroenterology, Digestive and Metabolic Diseases has identified such aspects and incorporated them into the respective recommendations.

  6. Gastroenterology training in Latin America.

    PubMed

    Cohen, Henry; Saenz, Roque; de Almeida Troncon, Luiz E; Lizarzabal, Maribel; Olano, Carolina

    2011-05-14

    Latin America is characterized by ethnic, geographical, cultural, and economic diversity; therefore, training in gastroenterology in the region must be considered in this context. The continent's medical education is characterized by a lack of standards and the volume of research continues to be relatively small. There is a multiplicity of events in general gastroenterology and in sub-disciplines, both at regional and local levels, which ensure that many colleagues have access to information. Medical education programs must be based on a clinical vision and be considered in close contact with the patients. The programs should be properly supervised, appropriately defined, and evaluated on a regular basis. The disparity between the patients' needs, the scarce resources available, and the pressures exerted by the health systems on doctors are frequent cited by those complaining of poor professionalism. Teaching development can play a critical role in ensuring the quality of teaching and learning in universities. Continuing professional development programs activities must be planned on the basis of the doctors' needs, with clearly defined objectives and using proper learning methodologies designed for adults. They must be evaluated and accredited by a competent body, so that they may become the basis of a professional regulatory system. The specialty has made progress in the last decades, offering doctors various possibilities for professional development. The world gastroenterology organization has contributed to the speciality through three distinctive, but closely inter-related, programs: Training Centers, Train-the-Trainers, and Global Guidelines, in which Latin America is deeply involved.

  7. Gastroenterology training in Latin America

    PubMed Central

    Cohen, Henry; Saenz, Roque; de Almeida Troncon, Luiz E; Lizarzabal, Maribel; Olano, Carolina

    2011-01-01

    Latin America is characterized by ethnic, geographical, cultural, and economic diversity; therefore, training in gastroenterology in the region must be considered in this context. The continent’s medical education is characterized by a lack of standards and the volume of research continues to be relatively small. There is a multiplicity of events in general gastroenterology and in sub-disciplines, both at regional and local levels, which ensure that many colleagues have access to information. Medical education programs must be based on a clinical vision and be considered in close contact with the patients. The programs should be properly supervised, appropriately defined, and evaluated on a regular basis. The disparity between the patients’ needs, the scarce resources available, and the pressures exerted by the health systems on doctors are frequent cited by those complaining of poor professionalism. Teaching development can play a critical role in ensuring the quality of teaching and learning in universities. Continuing professional development programs activities must be planned on the basis of the doctors’ needs, with clearly defined objectives and using proper learning methodologies designed for adults. They must be evaluated and accredited by a competent body, so that they may become the basis of a professional regulatory system. The specialty has made progress in the last decades, offering doctors various possibilities for professional development. The world gastroenterology organization has contributed to the speciality through three distinctive, but closely inter-related, programs: Training Centers, Train-the-Trainers, and Global Guidelines, in which Latin America is deeply involved. PMID:21633594

  8. Ethical issues in gastroenterology research.

    PubMed

    Eastwood, Gregory L

    2015-03-01

    Ethical issues have become increasingly important in gastroenterology research. This is for several reasons, including (i) an understanding of how conflicts of interest might affect research, (ii) the influence of the drug and device industries on research, (iii) ghostwriting (taking credit for something you did not write), (iv) the occurrence of ethically inappropriate research and scientific misconduct, and (v) respect for the rights of research subjects. These include the rights (i) to give informed consent to participate after understanding the purposes, risks, and benefits of the research; (ii) to ask questions; and (iii) to withdraw from participation at any time. Notions of doing good (beneficence), avoiding harm (non-maleficence), confidentiality, and, most important, the primacy of the welfare of the patient or research subject can be traced to antiquity. In the modern era, the Nuremburg Code (1947), the Declaration of Helsinki (1964), the Belmont report (1979), and other events and reports have led to the refinement of ethical practices in both clinical and research domains, have reinforced those long observed principles, and have given rise to the newer principles of autonomy and justice. The ethical conduct of research not only promotes good research but also is in the best interests of research subjects, investigators, sponsors, patients, and the public. © 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  9. The Gastroenterology Fellowship Match: A Decade Later.

    PubMed

    Huang, Robert J; Triadafilopoulos, George; Limsui, David

    2017-06-01

    Following a period of uncertainty and disorganization, the gastroenterology (GI) national leadership decided to reinstitute the fellowship match (the Match) under the auspices of the National Residency Matching Program (NRMP) in 2006. Although it has now been a decade since the rebirth of the Match, there have been limited data published regarding progress made. In this piece, we discuss reasons for the original collapse of the GI Match, including most notably a perceived oversupply of GI physicians and a poor job market. We discuss the negative impacts the absence of the Match had on programs and on applicants, as well as the impetus to reorganize the Match under the NRMP. We then utilize data published annually by the NRMP to demonstrate that in the decade since its rebirth, the GI Match has been remarkably successful in terms of attracting the participation of applicants and programs. We show that previous misguided concerns of an oversupply of GI physicians were not realized, and that GI fellowship positions remain highly competitive for internal medicine applicants. Finally, we discuss possible implications of recent changes in the healthcare landscape on the GI Match.

  10. Chronic Cough: A Gastroenterology Perspective

    PubMed Central

    Gawron, Andrew J.; Kahrilas, Peter J.; Pandolfino, John E.

    2014-01-01

    Purpose of review The purpose of this review is to highlight recent work and provide recommendations on the approach for diagnosis and management of chronic cough in a gastroenterology clinic. Recent findings Chronic cough is a burdensome symptom affecting a large number of patients and contributes significant cost to the healthcare system. Recent work has shown that select patients may benefit from acid suppressive therapy and even surgery when there is true pathologic evidence of reflux disease with cough. However, judicious use and proper interpretation of diagnostic testing for gastroesophageal reflux in the setting of cough is important to avoid unnecessary or inappropriate therapy. Summary Chronic cough remains a vexing problem for many physicians, including gastroenterologists. It is important that physicians approach refractory cough in a multi-disciplinary manner. Future research is needed to better understand the likely central hypersensitivity response mediating reflux related cough and potential alternative approaches to therapy. PMID:24240130

  11. Endoscopic laser therapy in gastroenterology.

    PubMed

    Pritikin, J; Weinman, D; Harmatz, A; Young, H

    1992-07-01

    Endoscopic laser therapy has become an important and widely used tool in gastroenterology. It has become important for outpatient palliative therapy for ablating obstructing gastrointestinal neoplasms. This method has often circumvented the need for major palliative surgical resections. Caution must be applied to laser therapy for potentially curable malignant neoplasms because, with vaporization of the target tissue, no tissue specimen is available to assure that local or invasive residual carcinoma is excluded. Therefore, in good surgical candidates, surgical resection of potentially curable cancers is always recommended. In the future, however, the combination of refined endoscopic ultrasonography and laser fluorescence techniques may lead to earlier detection, more precise localization, and even curative ablation of gastrointestinal malignancy.

  12. Endoscopic laser therapy in gastroenterology.

    PubMed Central

    Pritikin, J; Weinman, D; Harmatz, A; Young, H

    1992-01-01

    Endoscopic laser therapy has become an important and widely used tool in gastroenterology. It has become important for outpatient palliative therapy for ablating obstructing gastrointestinal neoplasms. This method has often circumvented the need for major palliative surgical resections. Caution must be applied to laser therapy for potentially curable malignant neoplasms because, with vaporization of the target tissue, no tissue specimen is available to assure that local or invasive residual carcinoma is excluded. Therefore, in good surgical candidates, surgical resection of potentially curable cancers is always recommended. In the future, however, the combination of refined endoscopic ultrasonography and laser fluorescence techniques may lead to earlier detection, more precise localization, and even curative ablation of gastrointestinal malignancy. Images PMID:1413743

  13. 21 CFR 876.4530 - Gastroenterology-urology fiberoptic retractor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology fiberoptic retractor. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4530 Gastroenterology-urology fiberoptic retractor. (a) Identification. A gastroenterology-urology fiberoptic retractor...

  14. 21 CFR 876.4370 - Gastroenterology-urology evacuator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology evacuator. 876.4370... (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4370 Gastroenterology-urology evacuator. (a) Identification. A gastroenterology-urology evacuator is a device used to remove...

  15. 21 CFR 876.4370 - Gastroenterology-urology evacuator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Gastroenterology-urology evacuator. 876.4370... (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4370 Gastroenterology-urology evacuator. (a) Identification. A gastroenterology-urology evacuator is a device used to remove...

  16. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology biopsy instrument. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1075 Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is a...

  17. 21 CFR 876.4530 - Gastroenterology-urology fiberoptic retractor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Gastroenterology-urology fiberoptic retractor. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4530 Gastroenterology-urology fiberoptic retractor. (a) Identification. A gastroenterology-urology fiberoptic retractor...

  18. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Gastroenterology-urology biopsy instrument. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Diagnostic Devices § 876.1075 Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is a...

  19. [Laser in gastroenterologic endoscopic therapy].

    PubMed

    Naveau, S; Chaput, J C

    1991-01-21

    Endoscopic gastrointestinal laser therapy was originally inspired by the haemostatic properties of the laser beam and was subsequently used to destroy tumours. In endoscopic gastroenterology, the most commonly used type of laser is the neodyme+-doped yttrium aluminium garnet (Nd:YAG) laser. Endoscopic Nd:YAG laser therapy of obstructive cancers of the oesophagus and cardia rapidly reduces dysphagia in 70 to 100% of the patients. In the treatment of colorectal cancers, the intestinal transit returns to normal in 57 to 83% of the cases, and rectal haemorrhages are controlled in 38 to 92% of the cases. However, sustained results can only be obtained by a maintenance treatment with at least one application every 4 weeks. The Nd:YAG laser makes it possible to destroy villose tumours in patients who cannot, or will not, be operated upon; the number of applications depends on the size of the tumour. Finally, the Nd:YAG laser seems to be able to control bleeding due to gastrointestinal angiodysplasia and to stabilize the course of Rendu-Osler-Weber disease.

  20. Nanomedicines in gastroenterology and hepatology.

    PubMed

    Lamprecht, Alf

    2015-04-01

    Nanoscale systems are currently under investigation for multiple different diagnostic and therapeutic applications. These systems can be used to identify pathologically changed tissues or to selectively deliver drugs to these sites; both applications have an extremely high potential to ameliorate therapeutic outcomes for patients. Tissues as well as single cells can be targeted because of the small size of these systems, which enables enhanced diagnosis and increased specificity of therapy. Drug loads can be delivered directly to the site of action, which can result in a reduction in incidence and severity of adverse systemic effects. Several nano-based platform technologies are currently under investigation for use in therapeutic approaches, mainly for anti-inflammatory and anti-cancer therapies. Although many nanoscale systems show promising therapeutic outcomes in preclinical studies, only a limited number are ready for clinical use. This Review will discuss the diverse nanomaterials currently available and the first specific uses for select gastroenterological and hepatological pathologies. The discussion of diagnostic and therapeutic applications will consider realities of market introduction of these sometimes very complex systems in light of remaining regulatory challenges and hurdles for industrial production.

  1. Pediatric Gastroenterology in Cuba: Evolution and Challenges.

    PubMed

    Castañeda-Guillot, Carlos

    2016-10-01

    INTRODUCTION The professional practice of pediatric gastroenterology arose in Cuba as an expression of the specialty's development internationally and Cuba's new strategies in public health, and in response to national needs for health care expertise in digestive diseases of infants, older children and adolescents. OBJECTIVES Describe the history of pediatric gastroenterology's development in Cuba since its inception at the National Gastroenterology Institute in the early 1970s, its contributions, and efforts to extend it to pediatric hospitals throughout Cuba. EVIDENCE ACQUISITION This is a historical review based on document analysis. Institutional sources from the National Gastroenterology Institute and Ministry of Public Health were reviewed, as well as international and national literature on the history of pediatric gastroenterology and unpublished texts since its emergence in 1972. DEVELOPMENT Although pediatric gastroenterology has not been formally recognized as a medical specialty in Cuba, there have been important achievements in establishing a network of specialized health care services for digestive diseases of children and adolescents. Gastrointestinal endoscopy and other auxiliary diagnostic modalities have been introduced for children and play a major role in clinical trials and research. This article describes the international context that promoted the specialty's development in Cuba. Reference is made to specialized training from its initial stages in 1972, its consolidation as an emerging discipline in Cuban medicine, and its diffusion in Latin American and Caribbean countries. Professional development and specialized training to meet health human resource needs in pediatric hospitals are described, as well as Cuban participation in the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition. National and international milestones, publications, awards and recognitions that indicate advances despite difficulties are also

  2. Transforming Gastroenterology Care With Telemedicine.

    PubMed

    Siegel, Corey A

    2017-04-01

    Health care is changing rapidly, so we must change with the times to develop more efficient, practical, cost-effective, and, importantly, high-quality methods to care for patients. We teach medical students that optimal patient care requires face-to-face interaction to collect information on the patient's history and perform the physical examination. However, management of many patients-especially those with chronic diseases-does not always require physical examination. Telemedicine offers an opportunity to take advantage of technology while leveraging the progressive push toward efficiency and value but also requires the belief that excellent patient care is not always provided in person. Telemedicine can include a variety of aspects of patient care adapted to be performed remotely, such as telemonitoring, tele-education, teleconsultation, and telecare. All of these have been evaluated in gastroenterology practice and have demonstrated feasibility and patient preference but have produced mixed results regarding patient outcomes. By combining telemedicine tools and new care models, we can redesign chronic disease management to include fewer in-person visits when patients are well yet increase access for patients who need to be seen. This change could lead to higher-value care by improving the experience of care, decreasing costs, and improving the health of the population. Barriers include reimbursement, licensing, and fear of litigation. However, if we hope to meet the needs of patients within our changing health care system, telemedicine should be incorporated into our strategy. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  3. Enhancing High Value Care in Gastroenterology Practice.

    PubMed

    Camilleri, Michael; Katzka, David A

    2016-10-01

    The objective of this review is to identify common areas in gastroenterology practice where studies performed provide an opportunity for enhancing value or lowering costs. We provide examples of topics in gastroenterology where clinicians could enhance value by either using less invasive testing, choosing a single best test, or by using patient symptoms to guide additional testing. The topics selected for review are selected in esophageal, pancreatic, and colorectal cancer; functional gastrointestinal diseases (irritable bowel syndrome, bacterial overgrowth, constipation); immune-mediated gastrointestinal diseases; and pancreaticobiliary pathology. We propose guidance to alter practice based on current evidence. These studies support the need to review current practice and to continue performing research to further validate the proposed guidance to enhance value of care in gastroenterology and hepatology. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  4. Gastroenterology in developing countries: Issues and advances

    PubMed Central

    Mandeville, Kate L; Krabshuis, Justus; Ladep, Nimzing Gwamzhi; Mulder, Chris JJ; Quigley, Eamonn MM; Khan, Shahid A

    2009-01-01

    Developing countries shoulder a considerable burden of gastroenterological disease. Infectious diseases in particular cause enormous morbidity and mortality. Diseases which afflict both western and developing countries are often seen in more florid forms in poorer countries. Innovative techniques continuously improve and update gastroenterological practice. However, advances in diagnosis and treatment which are commonplace in the West, have yet to reach many developing countries. Clinical guidelines, based on these advances and collated in resource-rich environments, lose their relevance outside these settings. In this two-part review, we first highlight the global burden of gastroenterological disease in three major areas: diarrhoeal diseases, hepatitis B, and Helicobacter pylori. Recent progress in their management is explored, with consideration of future solutions. The second part of the review focuses on the delivery of clinical services in developing countries. Inadequate numbers of healthcare workers hamper efforts to combat gastroenterological disease. Reasons for this shortage are examined, along with possibilities for increased specialist training. Endoscopy services, the mainstay of gastroenterology in the West, are in their infancy in many developing countries. The challenges faced by those setting up a service are illustrated by the example of a Nigerian endoscopy unit. Finally, we highlight the limited scope of many clinical guidelines produced in western countries. Guidelines which take account of resource limitations in the form of “cascades” are advocated in order to make these guidelines truly global. Recognition of the different working conditions facing practitioners worldwide is an important step towards narrowing the gap between gastroenterology in rich and poor countries. PMID:19533805

  5. Selected Convention Papers: 46th Annual International CEC Convention (New York, New York, April 14-20, 1968).

    ERIC Educational Resources Information Center

    Council for Exceptional Children, Arlington, VA.

    A collection of selected convention papers is presented on the following topics: the gifted child, children with behavioral disorders, the visually handicapped, programs in special education, the homebound and hospitalized, children with learning disabilities, international aspects of special education, general articles, administration programs,…

  6. Creutzfeldt-Jakob disease: implications for gastroenterology.

    PubMed

    Bramble, M G; Ironside, J W

    2002-06-01

    The current clinical views regarding variant Creutzfeldt-Jakob disease, and in particular transmission via endoscopy, of those representing both gastroenterology and the Spongiform Encephalopathy Advisory Committee are presented in an attempt to guide clinicians as to "best practice" given the current state of our knowledge.

  7. How the gastroenterology nurse can establish and meet career goals.

    PubMed

    Greenwald, Beverly

    2006-01-01

    A career goal promotes professional growth for the gastroenterology nurse. Short-term goals (achievable in less than one year) focus toward attaining a long-term goal (achievable in 5 to 10 years). The steps to achieving a career goal are self-assessment, career goal development, action plan development, implementation of the action plan, evaluation, and the establishment of a new goal. A career goal must be specific, measurable, achievable, realistic, and have a specified time frame. A tailor-made action plan is a list of interventions to promote goal achievement within the specified time frame. A goal posted in a prominent area is less likely to be forgotten and can guide day-to-day activities. A career goal should be reviewed and revised at least annually. A professional resume documents these career achievements.

  8. Professor Jerzy Kaulbersz, pioneer of Polish gastroenterology.

    PubMed

    Konturek, S J

    2011-04-01

    Jerzy Kaulbersz was undoubtedly the father of experimental gastroenterological physiology in Poland. He pioneered the neural and endocrine aspects of the mechanisms controlling gastric and pancreatic secretion by assessing the influence on this secretion of vagal nerves and endocrine factors such as gastrin, enterogastrone, urogastrone, pituitary, adrenal, thyroid and sex hormones as well as bile, hypoxia and X-ray irradiation. He introduced various models of peptic ulcerations such as induced by pylorus-ligation (Shay ulcers) or Mann-Williamson ulcers to test the influence of neuroendocrine factors on the formation and healing of these ulcerations. This review is designed to commemorate the outstanding contribution to experimental gastroenterology of Professor Kaulbersz, who first studied biology in German universities to obtain the title of Doctor of Natural Philosophy (Ph.D.) in Freiburg in 1913 and then completed medical studies at the Medical Faculty of the Jagiellonian University in Cracow receiving the title of Doctor of Universal Medicine (MD) in 1920. He then joined Department of Physiology of Jagiellonian University in Krakow as its assistant and gradually was appointed docent and finally promoted to professor in this Department, working here as chairman from 1934 to 1964 with only 7 years interruption when he spent the time of World War II in USA, working at various departments of experimental gastroenterology and publishing his outstanding papers in most prestigious physiology ournals such as American Journal of Physiology. He possessed comprehensive knowledge of physiology and was gifted to create and organize Cracow Department of Physiology. Moreover he became co-founder of the of Polish Physiological Society, the honorary member of American Physiological Association, honorary member of Polish Society of Gastroenterology and Physiology and received the diploma of Doctor Honoris Causa of Medical Academy in Cracow. This ad memoriam note commemorates his

  9. [Highlights in gastroenterology and hepatology 2013].

    PubMed

    Hessler, Roxane; Godat, Sébastien; Fraga, Montserrat; Burgmann, Konstantin; Doerig, Christopher; Deltenre, Pierre; Schoepfer, Alain

    2014-01-15

    This review highlights recent advances in gastroenterology and hepatology, including new insights into the diagnosis, pathogenesis and the treatment of ulcerative colitis, of achalasia, of irritable bowel syndrome, of chronic hepatitis B and of eosinophilic esophagitis. These new developments will be summarized and discussed critically, with a particular emphasis on their potential implications for current and future clinical practice. The recent advances on treatment of chronic hepatitis C will be published in another summary this year.

  10. [Gastroenterology in the new century in Venezuela. A first five years situational diagnosis].

    PubMed

    Lizarzábal de Belloso, Maribel

    2007-09-01

    Once the elaboration of CIE-10 Gastroenterology we used two indicators (Health and Management) as quantifiable measurements that reflect the critical success factors in the specialty. HEALTH INDICATORS: 13,21% of main medical complains in primary care concern to Gastroenterology. Four of them rank among the first 25 ("Diarrhea", "Abdominal pain", "Helmintiasis" and "Other Esophagus, Stomach and Bowel diseases"). At the specialty care, Acid-peptic disease ranked as the first main complain according with 56-73.3% of the gastroenterologist consulted (Public and Private care) followed by Gastrointestinal reflux, Irritable bowel, Constipation, Lithiasis, Diverticular disease, Hemorrhages, Jaundice, Cirrhosis, Amibiasis, Pancreatitis, Colon cancer, Polyps, Hepatitis and Colopathy. 11,4% of the total deaths among Venezuelans are by gastrointestinal causes and five of them count among the first 25, with wide regional variability. Trujillo reports major mortality by liver disease (3%) followed by Vargas, District Federal, Tachira (2.8%). Cirrhosis and Fibrosis are more frequent in Táchira (2.3%) Trujillo, Vargas (2,1%) Some regions report mainly infections and diarrheas. Major cancer mortality is in Táchira (6,73% of deaths in the State) followed by Merida and Trujillo. MANAGEMENT INDICATORS: Services Demand. 2,86 consult/habitant/year in internal medicine and 0.77 en specialties. Services Offer. 793 Gastroenterologists (3.4/10.000 habitants). 44.5% concentrated in D.Federal, followed by Táchira (3.9%) Carabobo, Zulia y Mérida. Human Resources Formation. 16 Post-graduated Programs graduate 70 gastroenterologists annually. The Gastroenterology Education Agreement 2006 unified the Venezuelan Gastroenterologist profile and the graduation requirements. The Venezuelan Gastroenterology Society, age 60, has extraordinary national and international projection through its scientific publication (GEN Magazine). This analysis of the present of Gastroenterology in Venezuela allows

  11. [Critical analysis of awards in gastroenterology research. The Mexican experience].

    PubMed

    Chávez-Tapia, Norberto C; Téllez-Avila, Félix I; Hernández-Calleros, Jorge; López-Arce, Gustavo; Franco-Guzmán, Ada; Uribe, Misael

    2008-01-01

    The impact of Mexican gastrointestinal research worldwide is limited and the outcome of the best research papers awarded by the Asociación Mexicana de Gastroenterología (AMG) is unknown. The objective of this study was to analyze the publication pattern of the research work, awarded by the AMG and their impact in international journals. The abstracts accepted for the annual meeting of the AMG from 1998 to 2006 were reviewed. Those presented in a plenary session or awarded were included. Their abstracts were searched in electronic databases. When not found, the main author was contacted by e-mail. In those papers published in a journal with an impact factor, the times it was cited were assessed. 35 abstracts were identified, mainly in gastroenterology (57.1%) and hepatology (34.3). Only in 5.7% (n=2) some of the authors were members of the governing board of AMG. The awarded institutions were Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (48.6%), Universities (Universidad Autónoma de Nuevo León, Universidad Nacional Autónoma de México and the Benemérita Universidad Autónoma de Puebla) (31.4%), Instituto Mexicano del Seguro Social (8.6%), Fundación Clínica Médica Sur (5.7%), Hospital Juárez (2.9%), Private hospital (2.9%). Most of the papers were published within a year (73.7%). Only 2 papers had more than 10 citations in another international journal with impact factor, with a median for all paper of 5 citations (0-45). Considering all institutions, the rate of publication is 48%. Only half of the awarded works were published and mainly in journals of local distribution. The impact of these studies worldwide is limited.

  12. The Bockus International Society of Gastroenterology: Historical review

    PubMed Central

    Chaun, Hugh

    2012-01-01

    The Bockus International Society of Gastroenterology was founded in 1958 in honour of Dr Henry L Bockus (1894–1982) by his former students, residents and fellows at the Graduate School of Medicine of the University of Pennsylvania, Philadelphia, USA. It was a celebrated tribute to Dr Bockus’ outstanding leadership in the development and teaching of clinical gastroenterology as a subspecialty, which was in its infancy in the post-World War II era. He established the first formal training course in clinical gastroenterology in America. His department of gastroenterology became the leading graduate school of clinical gastroenterology in the world, training many clinical gastroenterologists in America and from many regions around the world. For many years, Dr Bockus was the most prominent American in world gastroenterology. The Bockus Society holds biennial scientific congresses in different continents, thus continuing to foster Dr Bockus’ lifelong interest and vision to promote international medical friendship, and excellence in education and research collaboration. PMID:22506261

  13. 12th Update in Gastroenterology and Hepatology for the Primary Care Practitioner.

    PubMed

    Stephen, F Otis; Rossaro, Lorenzo

    2008-10-01

    The 12th Update in Gastroenterology and Hepatology for the Primary Care Practitioner is an annual course organized by the Division of Gastroenterology and Hepatology at the University of California, Davis, and held in beautiful Monterey, California. The course was geared towards primary care physicians, nurse practitioners and other allied health professionals. The goals of this symposium were to provide current information regarding the diagnosis and management of digestive diseases commonly seen in the primary care setting and to provide practical guidelines for disease management. Topics covered during this symposium included viral hepatitis, alcoholic liver disease, hepatocellular carcinoma, dysphagia, gastroesophageal reflux disease, chronic diarrhea, inflammatory bowel disease, irritable bowel syndrome, dyspepsia, gastroparesis and bariatric surgery. The course was organized into two sessions each morning, over 2 days, with three or four 30-min lectures. A brief question-and-answer session followed each lecture.

  14. Snapshot of an integrated psychosocial gastroenterology service

    PubMed Central

    Kinsinger, Sarah W; Ballou, Sarah; Keefer, Laurie

    2015-01-01

    AIM: To characterize the patients utilizing a gastroenterology behavioral medicine service and examine the effect of treatment on health care utilization. METHODS: Patients were referred by their gastroenterologists for psychological treatment during a 15 mo period. Patients seen for an intake with a psychologist completed the Brief Symptom Inventory (BSI) and a checklist of psychosocial concerns. A subset of patients with functional bowel disorders also completed a disease specific quality of life measure. Chart review was conducted to obtain information on type and frequency of sessions with the psychologist, the number of outpatient gastroenterology visits, and number of gastroenterology-related medical procedures during the 6 mo following psychological intake. RESULTS: Of 259 patients referred for treatment, 118 (46%) completed an intake with a psychologist. Diagnoses included: irritable bowel syndrome (42%), functional dyspepsia (20%), inflammatory bowel diseases (20%), esophageal symptoms (10%), and “other” (8%). Demographic variables and disease type did not differentiate between those who did and did not schedule an intake. Mean t-scores for the BSI global score index and the depression, anxiety, and somatization subscales fell below the cutoff for clinical significance (t = 63). Treatments were predominantly gut-directed hypnosis (48%) and cognitive behavioral therapy (44%). Average length of treatment was 4 sessions. Among functional gastrointestinal (GI) patients, those patients who initiated treatment received significantly fewer GI-related medical procedures during the 6 mo following the referral than patients who did not schedule an intake [t (197) = 2.69, P < 0.01]. CONCLUSION: Patients are receptive to psychological interventions for GI conditions and there is preliminary evidence that treatment can decrease health-care utilization among patients with functional GI conditions. PMID:25684957

  15. International comparisons of manpower in gastroenterology.

    PubMed

    Moayyedi, Paul; Tepper, Joshua; Hilsden, Robert; Rabeneck, Linda

    2007-03-01

    Health-care systems vary among countries and we were interested in how this might impact on gastroenterology manpower. We assessed the number of gastroenterologists in Canada and compared this with four countries where data were available over the Internet in either French or English. The number of gastroenterologists per 100,000 of the population was 3.9 in the United States, 3.48 in France, 2.1 in Australia, 1.83 in Canada, and 1.41 in the U.K. This variation in number of gastroenterologists was not reflected in the overall number of specialists per 100,000, which was similar in all five countries. Furthermore, the difference in gastroenterology manpower did not correlate with the amount of gross domestic product spent on health care. Countries with a low number of gastroenterologists per 100,000 all had a strong primary-care gatekeeper system, although this observation may be coincidental, as only five countries were studied. Canada had the most equitable distribution of gastroenterologists across the country with only modest differences among provinces. The United States had the most variation in the number of gastroenterologists per 100,000 of the population among states.

  16. Digestive oncologist in the gastroenterology training curriculum

    PubMed Central

    Mulder, Chris Jacob Johan; Peeters, Marc; Cats, Annemieke; Dahele, Anna; Droste, Jochim Terhaar sive

    2011-01-01

    Until the late 1980s, gastroenterology (GE) was considered a subspecialty of Internal Medicine. Today, GE also incorporates Hepatology. However, Digestive Oncology training is poorly defined in the Hepatogastroenterology (HGE)-curriculum. Therefore, a Digestive Oncology curriculum should be developed and this document might be a starting point for such a curriculum. HGE-specialists are increasingly resisting the paradigm in which they play only a diagnostic and technical role in the management of digestive tumors. We suggest minimum end-points in the standard HGE-curriculum for oncology, and recommend a focus year in the Netherlands for Digestive Oncology in the HGE-curriculum. To produce well-trained digestive oncologists, an advanced Digestive Oncology training program with specific qualifications in Digestive Oncology (2 years) has been developed. The schedule in Belgium includes a period of at least 6 mo to be spent in a medical oncology department. The goal of these programs remains the production of well-trained digestive oncologists. HGE specialists are part of the multidisciplinary oncological teams, and some have been administering chemotherapy in their countries for years. In this article, we provide a road map for the organization of a proper training in Digestive Oncology. We hope that the World Gastroenterology Organisation and other (inter)national societies will support the necessary certifications for this specific training in the HGE-curriculum. PMID:21556128

  17. PROCEEDINGS OF THE BIENNIAL CONVENTION OF THE AMERICAN ASSOCIATION OF INSTRUCTORS OF THE BLIND, INC. (46TH, MIAMI BEACH, FLORIDA, JUNE 28-JULY 2, 1962).

    ERIC Educational Resources Information Center

    American Association of Instructors of the Blind, St. Louis, MO.

    THE PUBLICATION REPORTS THE PROCEEDINGS OF THE 46TH BIENNIAL CONVENTION OF THE AMERICAN ASSOCIATION OF INSTRUCTORS OF THE BLIND (MIAMI BEACH, FLORIDA, JUNE 28-JULY 2, 1962). ADDRESSES, PAPERS, AND PANEL DISCUSSIONS COVER THE TOPICS OF MOBILITY, EDUCATIONAL RESEARCH, SELF CONCEPT IN BLIND CHILDREN, AND PHYSICAL FITNESS. ALSO INCLUDED ARE COMMITTEE…

  18. Nursing workload at a gastroenterology unit.

    PubMed

    Panunto, Marcia Raquel; Guirardello, Edinêis de Brito

    2009-01-01

    One of the biggest challenges nurses face is the need to justify the quantity and quality of staff for care delivery. For this, management instruments are available which help them to determine the staff needed in the nursing team. This descriptive study aims to evaluate the nursing workload at a specialized clinical and surgical gastroenterology unit. To collect data, the Nursing Activities Score (NAS) was used during 30 consecutive days, with 1080 comments, obtained from the records of 149 patients. The mean NAS score was 34.9% and, considering that each point of NAS corresponds to 0.24 hour, on the average, 8.4 hours of nursing care were required within 24 hours. This means that this profile is of patients who demand intermediate and semi-intensive care, which suggests that the NAS study can be used to evaluate the workload of nurses at that unit.

  19. The Mexican consensus on probiotics in gastroenterology.

    PubMed

    Valdovinos, M A; Montijo, E; Abreu, A T; Heller, S; González-Garay, A; Bacarreza, D; Bielsa-Fernández, M; Bojórquez-Ramos, M C; Bosques-Padilla, F; Burguete-García, A I; Carmona-Sánchez, R; Consuelo-Sánchez, A; Coss-Adame, E; Chávez-Barrera, J A; de Ariño, M; Flores-Calderón, J; Gómez-Escudero, O; González-Huezo, M S; Icaza-Chávez, M E; Larrosa-Haro, A; Morales-Arámbula, M; Murata, C; Ramírez-Mayans, J A; Remes-Troche, J M; Rizo-Robles, T; Peláez-Luna, M; Toro-Monjaraz, E M; Torre, A; Urquidi-Rivera, M E; Vázquez, R; Yamamoto-Furusho, J K; Guarner, F

    Probiotics are frequently prescribed in clinical practice. Their efficacy in treating gastrointestinal disorders is supported by a significant number of clinical trials. However, the correct prescription of these agents is hampered due to a lack of knowledge of the scientific evidence and to the different presentations and microbial compositions of the probiotics that are currently available. To provide the clinician with a consensus review of probiotics and recommendations for their use in gastroenterology. Controlled clinical trials, meta-analyses, and systematic reviews published up to 2015 were selected, using the MESH terms: probiotics, gastrointestinal diseases, humans, adults, AND children. The Delphi method was employed. Eighteen gastroenterologists treating adult patients and 14 pediatric gastroenterologists formulated statements that were voted on until agreement>70% was reached. The level of evidence based on the GRADE system was evaluated for each statement. Eleven statements on the general concepts of probiotics and 27 statements on the use of probiotics in gastrointestinal diseases in both adults and children were formulated. The consensus group recommends the use of probiotics under the following clinical conditions: the prevention of diarrhea associated with antibiotics, the treatment of acute infectious diarrhea, the prevention of Clostridium difficile infection and necrotizing enterocolitis, the reduction of adverse events from Helicobacter pylori eradication therapy, relief from irritable bowel syndrome symptoms, the treatment of functional constipation in the adult, and the induction and maintenance of remission in patients with ulcerative colitis and pouchitis, and the treatment of covert and overt hepatic encephalopathy. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  20. Development of gastroenterology and hepatology in Iran: part I-training programs and the Iranian association of gastroenterology and hepatology.

    PubMed

    Saberi-Firoozi, Mehdi; Mir-Madjlessi, Seid-Hossein

    2009-07-01

    During the first half of the 20th century, all subspecialties of internal medicine were managed by general internists and there was no gastroenterologist in Iran.1 The first group of Iranian gastroenterologists who had completed their training program in France started working in Tehran in 1951. Later on, other specialists trained in USA and the United Kingdom joined them. Some of these specialists and some internists with special interest in gastroenterology and hepatology were in charge of gastroenterology education in divisions of internal medicine in the Medical Schools of Tehran, Shiraz, Isfahan, and other universities, while most of them were also practicing gastroenterology in their private offices on a part-time basis. The establishment of subspecialty training program in gastroenterology and hepatology was firstly started in 1976 in Tehran University and later on and since 1984 in Shaheed Beheshti, and Shiraz Universities. This was a major step in the progress of this subspecialty, which is now one of the most active medical disciplines in Iran.2 In this paper, we aimed to describe the development and evolution of gastroenterology and hepatology in Iran during the last 60 years with emphasis on physicians and scientists, who played a major role in providing the first gastroenterology services in the country or had a major role in training, education, and research in this field. We also describe the attempts that led to the establishment of the Iranian Association of Gastroenterology and Hepatology, as the most important nongovernmental organization in this field.

  1. Recent advances in pediatric gastroenterology, hepatology and nutrition

    PubMed Central

    2013-01-01

    Pediatric gastroenterology, hepatology and nutrition are rapidly evolving, exciting and diverse disciplines. Because the field is so expansive, this commentary highlights important trends, rather than narrowly focusing on specific advances. Examples of advances in the highest impact and rapidly moving areas of pediatric gastroenterology are reviewed, including the intestinal microbiome, biomedical genomics, the biology of unique gastrointestinal cell types, and microRNAs (miRNAs). PMID:23864932

  2. Scandinavian epidemiological research in gastroenterology and hepatology.

    PubMed

    Björnsson, Einar S; Ekbom, Anders

    2015-06-01

    In the last decades, a large number of epidemiological studies in gastroenterology and hepatology have originated from the Scandinavian countries. With the help of large health databases, with good validity and other registries related to patient outcomes, researchers from the Scandinavian countries have been able to make some very important contributions to the field. These countries, Sweden, Norway, Finland, Denmark and Iceland, have all universal access to health care and have shown to be ideal for epidemiological research. Population-based studies have been frequent and follow-up studies have been able to describe the temporal trends and changes in phenotypes. Our ability in Scandinavia to follow up defined groups of patients over time has been crucial to learn the natural history of many gastrointestinal and liver diseases and often in a population-based setting. Patient-related outcomes measures will probably gain increasing importance in the future, but Scandinavian gastroenterologists and surgeons are likely to have a better infrastructure for such endeavors compared to most other populations. Thus, there is a bright future for international competitive research within the field of gastrointestinal and liver diseases in Scandinavia.

  3. Individualized Medicine in Gastroenterology and Hepatology.

    PubMed

    Stephens, Michael C; Boardman, Lisa A; Lazaridis, Konstantinos N

    2017-05-01

    After the completion of the Human Genome Project, there has been an acceleration in methodologies on sequencing nucleic acids (DNA and RNA) at a high precision and with ever-decreasing turnaround time and cost. Collectively, these approaches are termed next-generation sequencing and are already affecting the transformation of medical practice. In this symposium article, we highlight the current knowledge of the genetics of selected gastrointestinal tract and liver diseases, namely, inflammatory bowel disease, hereditary cholestatic liver disease, and familial colon cancer syndromes. In addition, we provide a stepwise approach to use next-generation sequencing methodologies for clinical practice with the goal to improve the diagnosis as well as management of and/or therapy of the chosen digestive diseases. This early experience of applying next-generation sequencing in the practice of gastroenterology and hepatology will delineate future best practices in the field, ultimately for the benefit of our patients. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  4. Metabolomics for Biomarker Discovery in Gastroenterological Cancer

    PubMed Central

    Nishiumi, Shin; Suzuki, Makoto; Kobayashi, Takashi; Matsubara, Atsuki; Azuma, Takeshi; Yoshida, Masaru

    2014-01-01

    The study of the omics cascade, which involves comprehensive investigations based on genomics, transcriptomics, proteomics, metabolomics, etc., has developed rapidly and now plays an important role in life science research. Among such analyses, metabolome analysis, in which the concentrations of low molecular weight metabolites are comprehensively analyzed, has rapidly developed along with improvements in analytical technology, and hence, has been applied to a variety of research fields including the clinical, cell biology, and plant/food science fields. The metabolome represents the endpoint of the omics cascade and is also the closest point in the cascade to the phenotype. Moreover, it is affected by variations in not only the expression but also the enzymatic activity of several proteins. Therefore, metabolome analysis can be a useful approach for finding effective diagnostic markers and examining unknown pathological conditions. The number of studies involving metabolome analysis has recently been increasing year-on-year. Here, we describe the findings of studies that used metabolome analysis to attempt to discover biomarker candidates for gastroenterological cancer and discuss metabolome analysis-based disease diagnosis. PMID:25003943

  5. [Why are there few publications by the Argentine gastroenterology? Considerations on a bibliometric analysis of Argentine publications on gastroenterology].

    PubMed

    Barreyro, Fernando J; Krabshuis, Justus; Planzer del Campo, Marcela; Bai, Julio C

    2009-03-01

    The publication of scientific findings is the main way to communicate advances. Our aim was to perform a bibliometric and comparative analysis of the Argentinean gastroenterological research output. We analyzed Argentinean gastroenterological publications selectively retrieved from LILACS (between years 1982-2006) and EMBASE (1996-2007) databases by means of specially constructed filter based on author address and subject headings. The global Argentinean scientific research output is far below that of developed countries and has been affected in direct manner by economic, political and social disturbances in the country. The gastroenterological research output from Argentina represent about 6% of national biomedical research. While 54% belongs to gastroenterology and 46% to hepatology, 65% are based on clinical research and 67% were originally contributions. Only 11% have been published in high impact factor journals. The comparative analysis within countries with health indicators similarities has shown a low biomedical and gastroenterology research output, however, the rate of acceptance at the 18 top gastroenterological journals is acceptable (15%). The contributions of registered specialists were lower for gastroenterologists compared with those from hepatologists (8.7% and 16.4% respectively). The research projects at public hospital funded by the pharmaceutical industry overcome those funded independently. Indeed, it seems that the independent research is being progressively replaced by that supported by the industry due to economic benefits for researchers even when there is a very low participation rate in publications (3%) by Argentinean researchers. We conclude that the Argentinean biomedical and gastroenterological research output is scanty compared with developed countries and countries with comparable health indicators. Our analysis suggests that efforts must be taken to attain objectives directed to develop and improve the Argentinean biomedical and

  6. Transition of gastroenterological patients from paediatric to adult care: A position statement by the Italian Societies of Gastroenterology.

    PubMed

    Elli, Luca; Maieron, Roberto; Martelossi, Stefano; Guariso, Graziella; Buscarini, Elisabetta; Conte, Dario; di Giulio, Emilio; Staiano, Annamaria; Barp, Jacopo; Bassotti, Gabrio; Bianco, Maria Antonia; Buri, Luigi; Carrara, Maurizio; Ghidini, Benedetta; Giannini, Olivia; Knafelz, Daniela; Miele, Erasmo; Peralta, Sergio; Riccio, Elisabetta; Tomba, Carolina; Zilli, Maurizio; Guadagnini, Tiziana

    2015-09-01

    In 2013, four Italian Gastroenterological Societies (the Italian Society of Paediatric Gastroenterology, Hepatology and Nutrition, the Italian Society of Hospital Gastroenterologists and Endoscopists, the Italian Society of Endoscopy, and the Italian Society of Gastroenterology) formed a joint panel of experts with the aim of preparing an official statement on transition medicine in Gastroenterology. The transition of adolescents from paediatric to adult care is a crucial moment in managing chronic diseases such as celiac disease, inflammatory bowel disease, liver disease and liver transplantation. Improved medical treatment and availability of new drugs and surgical techniques have improved the prognosis of many paediatric disorders, prolonging survival, thus making the transition to adulthood possible and necessary. An inappropriate transition or the incomplete transmission of data from the paediatrician to the adult Gastroenterologist can dramatically decrease compliance to treatment and prognosis of a young patient, particularly in the case of severe disorders. For these reasons, the Italian gastroenterological societies decided to develop an official shared transition protocol. The resulting document discusses the factors influencing the transition process and highlights the main points to accomplish to optimize compliance and prognosis of gastroenterological patients during the difficult transition from childhood to adolescence and adulthood.

  7. "Bending the cost curve" in gastroenterology.

    PubMed

    Slattery, E; Harewood, G C; Murray, F; Patchett, S

    2013-12-01

    Increasing attention is being focused on reigning in escalating costs of healthcare, i.e. trying to 'bend the cost curve'. In gastroenterology (GI), inpatient hospital care represents a major component of overall costs. This study aimed to characterize the trend in cost of care for GI-related hospitalizations in recent years and to identify the most costly diagnostic groups. All hospital inpatients admitted between January 2008 and December 2009 with a primary diagnosis of one of the six most common GI-related Diagnosis Related Groups (DRGs) in this hospital system were identified; all DRGs contained at least 40 patients during the study period. Patient Level Costing (PLC) was used to express the total cost of hospital care for each patient; PLC comprised a weighted daily bed cost plus cost of all medical services provided (e.g., radiology, pathology tests) calculated according to an activity-based costing approach; cost of medications were excluded. All costs were discounted to 2009 values. Mean length of stay (LOS) was also calculated for each DRG. Over 2 years, 470 patients were admitted with one of the six most common GI DRGs. Mean cost of care increased from 2008 to 2009 for all six DRGs with the steepest increases seen in 'GI hemorrhage (non-complex)' (31 % increase) and 'Cirrhosis/Alcoholic hepatitis (non-complex)' (45 % increase). No differences in readmission rates were observed over time. There was a strong correlation between year-to-year change in costs and change in mean LOS, r = 0.93. The cost of GI-related inpatient care appears to be increasing in recent years with the steepest increases observed in non-complex GI hemorrhage and non-complex Cirrhosis/Alcoholic hepatitis. Efforts to control the increasing costs should focus on these diagnostic categories.

  8. View from the Top: Perspectives on Women in Gastroenterology from Society Leaders.

    PubMed

    Schmitt, Colleen M; Allen, John I

    2016-06-01

    Women are making great strides at all levels of medicine, including gastroenterology. The proportion of women members in gastroenterology societies has increased nearly 2-fold and the percent of women trainees is 36%. Although there continue to be challenges for women in academic and community practice, the American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and other gastroenterology societies have dedicated substantial resources to foster careers of women in gastroenterology and develop women as leaders in our societies. This article outlines ongoing challenges for women in gastroenterology and some key initiatives addressing barriers to success. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Quality of gastroenterology research published in Saudi Arabian scientific journals.

    PubMed

    Almaghrabi, Majed M; Alamoudi, Abdullah S; Radi, Suhaib A; Merdad, Anas A; Makhdoum, Ahmad M; Batwa, Faisal A

    2015-01-01

    Evidence-based medicine has established itself in the field of gastroenterology. In this study we aim to assess the types of study designs of gastroenterology-related articles published in Saudi scientific journals. An online review using PubMed was carried out to review gastroenterology-related articles published in six Saudi medical journals in the time interval from 2003 to 2012. To classify the level of evidence in these articles we employed the Oxford's levels of evidence. One-way analysis of variance was used to compare the levels of evidence between published articles. A total of 721 gastroenterology-related articles were reviewed, of which 591 articles met our inclusion criteria; 80.7% were level IV. The three most common types of studies we encountered were cross-sectional (33.9%), case reports (27.9%), and case series (18.8%). Forty-three percent of the published research was in the field of hepatobiliary and spleen. The total number of articles increased from 260 articles in the 1 st 5-year period (2003-2007) to 330 in the 2 nd period (2008-2012). However, no statistically significant difference in the level of evidence was noted. In Annals of Saudi Medicine Journal, articles with level II increased from 0 to 10% with a P value 0.02. In our review of gastroenterology-related published articles in Saudi scientific journals, we observed an increase in the quantity of articles with the quality and level of evidence remaining unchanged. Further research is recommended to explore different reasons affecting the volume and quality of gastroenterology-related research in Saudi scientific journals.

  10. Gastroenterology - Evolution of specialty choice in recent years.

    PubMed

    Curbelo, José; Galván-Román, José-María; Sánchez-Lasheras, Fernando; Romeo, Jose María; Fernández-Somoano, Ana; Villacampa, Tomás; Baladrón, Jaime

    2017-09-01

    Gastroenterology is one of the medical specialties offered to residency training candidates each year. This project analyzes the data associated with the choice of a Gastroenterology residency program in recent years. Data related to specialty selection were obtained from official reports with regard to the allocation of residency places by the Spanish Ministry of Health, Social Services and Equality. Information was collected from various teaching centers via their training guides, the Spanish National Catalogue of Hospitals and the National Transplant Organization. The median consecutive number involved in the choice of Gastroenterology training has decreased year after year, and this specialty is now positioned among the five most commonly selected residency programs in 2015. The median number of hospitals with a higher number of beds, adult liver transplantation activities and dedicated GI bleeding units is significantly lower. This is also true when centers are analyzed according to the presence of specific Gastroenterology on-call shifts for residents or their association with medical schools. Data from the past five years highlight Madrid, Aragón and the Basque Country as the autonomous communities where Gastroenterology is the most popular. Centers selected by candidates with the lowest median consecutive numbers from 2011-2015 included the university hospitals Ramón y Cajal, Santiago de Compostela and Gregorio Marañón. Gastroenterology has gradually escalated in the ranking of residency choices and is now one of the five most popular options. Potential residents prefer larger centers with complex-care patients and more research activity.

  11. Variations of author origins in World Journal of Gastroenterology during 2001-2007.

    PubMed

    Yang, Hua; Zhao, Yue-Yang

    2008-05-21

    To discuss the variations and distributions of authors who published their papers in World Journal of Gastroenterology (WJG) during 2001-2007 and evaluate the development of WJG and gastroenterology core journals in recent years by comparing the contributions of the authors. WJG articles published in 2001-2007 were searched from MEDLINE database (by ISI Web of Knowledge). The variations (cooperation degree, cooperation rate) and distributions of the first authors were analyzed with bibliometric methods. SCIE was used to collect articles published in Am J Gastroenterol, Gastroenterology, Scand J Gastroenterol and WJG in 2007, and comparison of the data was made. Comparison indicators included the article number of annual journals, cooperation degree of authors, cooperation rate, mean number of articles published in each WJG issue, number of countries of the first WJG authors, geographical distribution and article contribution ratio of all WJG authors and domestic authors. Of the 5851 articles covered in MEDLINE, 173, 236, 633, 826, 1496, 1382 and 1105 articles were cited from 2001 to 2007. The cooperation degree was 5.11, 5.56, 5.75, 5.76, 6.31, 5.90 and 5.64 respectively. The cooperation rates was 94.80%, 99.15%, 98.89%, 98.55%, 99.13%, 96.67% and 95.66%, respectively. The mean number of articles published in each WJG issue from 2001 to 2007 was 28, 39, 52, 34, 31, 28 and 23, respectively. The number of countries of the first WJG authors was 8, 8, 27, 32, 49, 61 and 56, respectively. The first authors of WJG came from 3 continents in 2001 and covered 6 continents in 2006-2007. The number of articles written by Asian authors was 136 (79.07%), 227 (96.19%), 575 (90.98%), 713 (87.81%), 1111 (75.32%), 712 (53.98%) and 555 (53.21%), respectively in 2001-2007. The number of articles written by European & American authors increased from 36 (20.93%) and 8 (3.39%) in 2001-2002 to 563 (42.68%) and 452(43.34%) in 2006-2007. The number of countries except for China

  12. 21 CFR 876.4730 - Manual gastroenterology-urology surgical instrument and accessories.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual gastroenterology-urology surgical... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4730 Manual gastroenterology-urology surgical instrument and accessories. (a) Identification...

  13. 21 CFR 876.4730 - Manual gastroenterology-urology surgical instrument and accessories.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Manual gastroenterology-urology surgical... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4730 Manual gastroenterology-urology surgical instrument and accessories. (a) Identification...

  14. 21 CFR 876.4370 - Gastroenterology-urology evacuator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Gastroenterology-urology evacuator. 876.4370 Section 876.4370 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... evacuator, and the AC-powered vacuum pump. (b) Classification. (1) Class II (special controls) for...

  15. Global Health Education in Gastroenterology Fellowship: A National Survey.

    PubMed

    Jirapinyo, Pichamol; Hunt, Rachel S; Tabak, Ying P; Proctor, Deborah D; Makrauer, Frederick L

    2016-12-01

    Interest in global health (GH) education is increasing across disciplines. To assess exposure to and perception of GH training among gastroenterology fellows and program directors across the USA. Design: Electronic survey study. The questionnaire was circulated to accredited US gastroenterology fellowship programs, with the assistance of the American Gastroenterological Association. Gastroenterology program directors and fellows. The questionnaire was returned by 127 respondents (47 program directors, 78 fellows) from 55 training programs (36 % of all training programs). 61 % of respondents had prior experience in GH. 17 % of programs offered GH curriculum with international elective (13 %), didactic (9 %), and research activity (7 %) being the most common. Fellows had adequate experience managing hepatitis B (93 %), cholangiocarcinoma (84 %), and intrahepatic duct stones (84 %). 74, 69 and 68 % reported having little to no experience managing hepatitis E, tuberculosis mesenteritis, or epidemic infectious enteritis, respectively. Most fellows would participate in an elective in an underserved area locally (81 %) or a 4-week elective abroad (71 %), if available. 44 % of fellows planned on working or volunteering abroad after fellowship. Barriers to establishing GH curriculum included funding (94 %), scheduling (88 %), and a lack of standardized objectives (78 %). Lack of interest, however, was not a concern. Fellows (49 %), more than faculty (29 %) (χ (2) = 21.9; p = 0.03), believed that GH education should be included in fellowship curriculum. Program directors and trainees recognize the importance of GH education. However, only 17 % of ACGME-approved fellowship programs offer the opportunity. Global health curriculum may enhance gastroenterology training.

  16. Current status of endoscopic simulation in gastroenterology fellowship training programs.

    PubMed

    Jirapinyo, Pichamol; Thompson, Christopher C

    2015-07-01

    Recent guidelines have encouraged gastroenterology and surgical training programs to integrate simulation into their core endoscopic curricula. However, the role that simulation currently has within training programs is unknown. This study aims to assess the current status of simulation among gastroenterology fellowship programs. This questionnaire study consisted of 38 fields divided into two sections. The first section queried program directors' experience on simulation and assessed the current status of simulation at their institution. The second portion surveyed their opinion on the potential role of simulation on the training curriculum. The study was conducted at the 2013 American Gastroenterological Association Training Directors' Workshop in Phoenix, Arizona. The participants were program directors from Accreditation Council for Graduate Medical Education accredited gastroenterology training programs, who attended the workshop. The questionnaire was returned by 69 of 97 program directors (response rate of 71%). 42% of programs had an endoscopic simulator. Computerized simulators (61.5%) were the most common, followed by mechanical (30.8%) and animal tissue (7.7%) simulators, respectively. Eleven programs (15%) required fellows to use simulation prior to clinical cases. Only one program has a minimum number of hours fellows have to participate in simulation training. Current simulators are deemed as easy to use (76%) and good educational tools (65%). Problems are cost (72%) and accessibility (69%). The majority of program directors believe that there is a need for endoscopic simulator training, with only 8% disagreeing. Additionally, a majority believe there is a role for simulation prior to initiation of clinical cases with 15% disagreeing. Gastroenterology fellowship program directors widely recognize the importance of simulation. Nevertheless, simulation is used by only 42% of programs and only 15% of programs require that trainees use simulation prior to

  17. 2015 American Journal of Gastroenterology Lecture: How Digital Health Will Transform Gastroenterology.

    PubMed

    Spiegel, Brennan

    2016-05-01

    Our patients spend most of their lives far away from an examination room. If we are truly going to capture our patients' attention and engage them in their care, then we must reach beyond the four walls of the clinic, hospital, or endoscopy suite. This is the vision of the digital health movement-an effort to monitor patients remotely and dynamically with mobile health ("mHealth") smartphone applications, electronic health record portals, social media, and wearable biosensors to improve health care outside of the clinical trenches. This article explores how advances in digital health may improve health-care delivery, focusing on gastroenterology and hepatology. It describes how technology can monitor patients remotely, improve face-to-face care, drive clinical decisions, and offer value to health-care organizations, their patients, and their staff. The article also describes pitfalls and shortcomings of digital technologies and concludes by describing a new model for how digital health can be deployed at scale to improve coordination and outcomes of care.

  18. Association between the participation of board-certified surgeons in gastroenterological surgery and operative mortality after eight gastroenterological procedures.

    PubMed

    Konno, Hiroyuki; Kamiya, Kinji; Kikuchi, Hirotoshi; Miyata, Hiroaki; Hirahara, Norimichi; Gotoh, Mitsukazu; Wakabayashi, Go; Ohta, Tetsuo; Kokudo, Norihiro; Mori, Masaki; Seto, Yasuyuki

    2017-05-01

    The aim of this study is to evaluate the association between the participation of board-certified surgeons in gastroenterological surgery (BCS-Gs) and the surgical outcomes of gastroenterological surgery. Data from the National Clinical Database on patients who underwent eight major gastroenterological procedures were analyzed retrospectively. First, the ratio of cases in which BCS-G were involved to the total cases was calculated for each procedure, and the impact of BCS-G involvement on surgical outcome was assessed by comparing mortality rates in the group with BCS-G involvement vs. the group without BCS-G involvement. Second, the differences in the observed/expected ratio were assessed among four hospital categories according to the available BCS-G number. Finally, the impact of the hospital BCS-G number on mortality was evaluated. The ratio of BCS-G involvement ranged from 59.0 % for acute diffuse peritonitis to 89.1 % for hepatectomy, and the mortality rate was significantly lower for three procedures when BCS-Gs participated as the operator or assistant. The observed/expected ratio of hospitals with four or more BCS-Gs was less than 1.0 for all the procedures assessed. A multivariable logistic regression model showed that the hospital BCS-G number was a predictor of operative mortality. BCS-Gs contribute to favorable outcomes of gastroenterological surgery in Japan. The hospital BCS-G number is a surrogate marker of operative mortality.

  19. The Bowker Annual: Library and Book Trade Almanac[TM], 2001.

    ERIC Educational Resources Information Center

    Bogart, Dave, Ed.

    This 46th edition of the "Bowker Annual" chronicles another year of rapid evaluation as the library and book trade worlds adapt to the many changes wrought by new technologies. Electronic information is now key to virtually every aspect of both industries, and decisions on its best presentation and organization offer constant challenges and…

  20. Clinical nutrition in medical gastroenterology: room for improvement.

    PubMed

    Johansson, Ulla; Rasmussen, Henrik Höjgaard; Mowe, Morten; Staun, Michael

    2009-04-01

    Undernutrition is a problem in hospitals, with lack of nutritional routines. Recently, guidelines concerning the nutritional care process were developed from ESPEN. This study was conducted to assess the present status of nutritional routines among doctors and nurses in internal medicine (IM) and medical gastroenterology (MG), in comparison with the ESPEN guidelines. A questionnaire-based investigation among doctors and nurses working in departments of internal medicine and gastroenterology in Scandinavia, based on further analysis of previous data. Overall, 4512 (1753 doctors, 2759 nurses) answered the questionnaire, of which 1155 were from internal medicine and 193 from gastroenterology. A similar, non-significant, discrepancy in attitudes and nutritional routines was noted in gastroenterologists and internists. Concerning basic nutritional education, 46% in MG and 48% in IM considered it insufficient (not significant). When comparing all doctors with all nurses, 60% and 39% respectively considered their basic nutritional education insufficient (p<0.001). Concerning prescription of parenteral nutrition, 65% of the internists and 92% of the gastroenterologists had sufficient knowledge (p<0.001), while technical skill did not differ (not significant). Lack of interest was more pronounced in the internists than in the gastroenterologists, 42% vs. 32% (p<0.05), and more pronounced in doctors when comparing all doctors with all nurses (47 vs. 36%, p<0.001). A discrepancy between clinical practice and attitudes towards nutrition is evident in both gastroenterology and internal medicine. Although gastroenterologists are more interested, there is room for improvement in both groups. This is true for doctors as well as nurses, even though nurses seem to be more interested and better trained than doctors.

  1. Gastroenterology, a historical specialty with a great future.

    PubMed

    Crespo, Javier; Jorquera Plaza, Francisco

    2017-09-01

    The specialty of gastroenterology (SGI) deals with the conditions involving the gut (esophagus, stomach, bowels, anorectal region), liver, bile ducts, pancreas, and peritoneum, specifically with their etiology, epidemiology, pathophysiology, semiology, diagnosis, prognosis, prevention, and treatment. As shown by Dr. Curbelo et al. in the present issue of The Spanish Journal of Digestive Diseases (Revista Española de Enfermedades Digestivas), our SGI has progressively grown as a specialty training option, and is now one of the five most commonly requested residency programs.

  2. possible role of soluble fibrin monomer complex after gastroenterological surgery

    PubMed Central

    Kochi, Masatoshi; Shimomura, Manabu; Hinoi, Takao; Egi, Hiroyuki; Tanabe, Kazuaki; Ishizaki, Yasuyo; Adachi, Tomohiro; Tashiro, Hirotaka; Ohdan, Hideki

    2017-01-01

    AIM To examine the role of soluble fibrin monomer complex (SFMC) in the prediction of hypercoagulable state after gastroenterological surgery. METHODS We collected data on the clinical risk factors and fibrin-related makers from patients who underwent gastroenterological surgery at Hiroshima University Hospital between April 1, 2014 and March 31, 2015. We investigated the clinical significance of SFMC, which is known to reflect the early plasmatic activation of coagulation, in the view of these fibrin related markers. RESULTS A total of 123 patients were included in the present study. There were no patients with symptomatic VTE. Thirty-five (28%) patients received postoperative anticoagulant therapy. In the multivariate analysis, a high SFMC level on POD 1 was independently associated with D-dimer elevation on POD 7 (OR = 4.31, 95%CI: 1.10-18.30, P = 0.03). The cutoff SFMC level was 3.8 μg/mL (AUC = 0.78, sensitivity, 63%, specificity, 89%). The D-dimer level on POD 7 was significantly reduced in high-SFMC patients who received anticoagulant therapy in comparison to high-SFMC patients who did not. CONCLUSION The SFMC on POD 1 strongly predicted the hypercoagulable state after gastroenterological surgery than the clinical risk factors and the other fibrin related markers. PMID:28405149

  3. An evaluation of patient attitudes to the gastroenterology outpatient experience.

    PubMed

    Larkins, Amy S; Windsor, Amy V C; Trebble, Timothy M

    2013-01-01

    To determine patient attitudes in gastroenterology outpatient care, including the preferences and expectations associated with satisfaction, waiting times and quality in the consultation. A service evaluation of patient care in outpatient gastroenterology clinics was carried out using a composite, dedicated self-completed questionnaire; this included demographics, preconsultation and postconsultation Likert scale attitudes to process, interactive and environmental factors and a 16-point ranking questionnaire of domains of the patient pathway considered important to obtaining satisfaction. Two hundred and twenty-seven patients agreed to participate. The factors considered most important to obtaining satisfaction related to the quality of the consultation, including 'seeing the doctor', 'having confidence in the treatment plan', 'clear and appropriately set explanations', 'being listened to', 'opportunity to express important issues' and 'recognition of needs'. Low importance was attributed to process and environmental aspects including waiting times (appointment and waiting room), explanations for delays and the quietness and privacy of the consultation room, and involvement of the patient's next of kin. Patients reported dissatisfaction with long waiting times and short consultation times, but this did not appear to influence postconsultation satisfaction, the likelihood of reattendance or following the treatment plan. Patients consider that factors most important to a satisfactory experience in gastroenterology outpatient care relate specifically to the quality of their interaction with their healthcare professional in consultation. The roles of environmental and process issues are considered less important.

  4. Gastroenterologic endoscopy in children: past, present, and future.

    PubMed

    Gilger, M A

    2001-10-01

    Perhaps it was the innate human fear of the dark, or the recognition that health was linked in some way to diet. Maybe it was the Hippocratic description of dyspepsia. Whatever the reason, the human desire to peer inside the body was a driving force in the development of endoscopy. The field of gastroenterology began with the Phillip Bozzini's crude, candle-powered lichtleiter in 1805 and blossomed with the introduction of flexible gastrointestinal endoscopy by Basil Hirschowitz in the late 1950s. Pediatric gastroenterology began early 1970s. Fueled by the application of gastrointestinal endoscopy to childhood digestive disease, pediatric gastroenterology has emerged as one of the most diverse medical-surgical practices in modern medicine. Pediatric endoscopists are alerted to prolapse gastropathy, a more accurate description of an old and possibly common cause of upper gastrointestinal bleeding in children. Pediatric endoscopic retrograde cholangiopancreatography continues to evolve, with increasing use in the diagnosis of infant cholestasis and endoscopic treatment of pancreatitis. These developments suggest a need for advanced training in endoscopy for pediatric gastroenterologists. Trends in gastrointestinal endoscopy are moving toward more therapeutic procedures and less diagnostic endoscopy. Therapeutic endoscopy, for example, may soon include antireflux operations. Computer-assisted virtual endoscopy and the wireless pill videoendoscope may replace diagnostic endoscopy eventually. The purpose of this review is to explore the origins of pediatric endoscopy, discuss current innovations, and look at the future of our discipline.

  5. [Economic aspects of ultrasound diagnostics in gastroenterological outpatient care].

    PubMed

    Weidenhiller, S

    2003-04-01

    Due to new examination techniques, the quality of gastroenterological ultrasound diagnostics has improved considerably in the last few years. In the long term these techniques are an indispensable requirement for competent examinations. However, the price of such high-quality apparatus has increased considerably. To ascertain the financial prerequisites for highly specialised ultrasound services in a gastroenterological out-patient department. Systematic determination of costs and income from ultrasound diagnostics within the public health system for the second quarter of 2001 (KV Bayern) and precise definition of the cost of individual services. We apply the results obtained to other settings e.g. in-patient departments. The use of a grade 3 ultrasound appliance (DEGUM criteria) is cost-effective on the basis of 1940 examinations per year within taking a fictitious physician's fee into account. Based on a fee of 50.00 Euros per hour, an examination frequency of 5,834 per year would be required, whereas a fee of 100.00 Euros per hour could not be recovered even by an extremely large number of examinations. The present fee paid by the public health sector does not cover the expenses of a grade 3 ultrasound appliance. We discuss feasible solutions for offering a highly specialized, customer-friendly and cost-effective method for ultrasound examinations within the gastroenterological practice.

  6. [Bibliometric analysis of publications in Gastroenterology and Hepatology in Spain from 2000 to 2009].

    PubMed

    Iñigo, Jesús; García-Samaniego, Javier

    2012-10-01

    The aim of this study was to analyze the productivity and visibility of Spanish authors in gastroenterology and hepatology between 2000 and 2009 and to compare the results with those for other countries. The Web of Science database was used. The analysis (annual and 5-yearly) was restricted to citable documents. The bibliometric indicators used were the number of documents published, the total number of citations received, the median and interquartile range of the citations received and the Hirsch h index. We identified 82,740 documents, with an increase of 18.2% between 5-year periods. Seventeen countries published more than 1,000 documents in the decade and received more than 20,000 citations. A total of 14.5% of the documents were international collaborations (20.6% of all citations) and 37.3% were published in journals in the first quartile (66.3% of all citations). The median number of citations received by all the publications was 9 (interquartile range: 3-21) and their h index was 246. Spain ranked ninth for the number of documents and eighth for citations received and for the h index. The countries showing the greatest increase in the percentage of citations contributing to the world total were Canada and Spain, with an increase between 5-yearly periods of 1.16% and 0.95%, respectively. From 2000 to 2009, the production of Spanish authors in gastroenterology and hepatology was high, achieving a notable position in the total number of citations received. Copyright © 2012 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  7. International gastroenterology research: subject areas, impact, and funding

    PubMed Central

    Lewison, G; Grant, J; Jansen, P

    2001-01-01

    AIMS—To examine the volume and potential impact of gastroenterology research outputs from 1985 to 1998 from 14 developed countries; the overlap with research in cancer, infectious diseases, and genetics; and the funding sources for this research. To determine if countries' research outputs correlated with their burden of corresponding diseases and inputs to their research.
METHODS—Selective retrieval of papers from the Science Citation Index and manual look up of a sample to determine funding sources. Classification of journals by four categories of research level (clinical/basic) and potential impact (low/high).
RESULTS—Gastroenterology represents about 8% of world biomedical research but over 11% in Italy, Japan, and Spain. Its potential impact is highest (but declining) for the USA. It has increased noticeably in most European countries, particularly in Finland. Gastroenterology research has become more clinical in Japan, Spain, Australia, and the Netherlands but more basic in Canada, Germany, Finland, Israel, and South Africa. Funding comes primarily from national governments, followed by national private non-profit sources and industry but little industrial funding occurs in some countries. There is a strong and positive correlation between reported deaths from gastrointestinal neoplasms and countries' outputs of research in gastrointestinal oncology.
CONCLUSIONS—Bibliometric analysis can reveal differences between countries in their research in a subject when a common methodology is applied to an international database. Variations in research methods in different countries can plausibly explain some of the variation in the potential impact of the work.


Keywords: bibliometrics; funding; impact; mortality; research PMID:11454809

  8. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU).

    PubMed

    Löhr, J Matthias; Dominguez-Munoz, Enrique; Rosendahl, Jonas; Besselink, Marc; Mayerle, Julia; Lerch, Markus M; Haas, Stephan; Akisik, Fatih; Kartalis, Nikolaos; Iglesias-Garcia, Julio; Keller, Jutta; Boermeester, Marja; Werner, Jens; Dumonceau, Jean-Marc; Fockens, Paul; Drewes, Asbjorn; Ceyhan, Gürlap; Lindkvist, Björn; Drenth, Joost; Ewald, Nils; Hardt, Philip; de Madaria, Enrique; Witt, Heiko; Schneider, Alexander; Manfredi, Riccardo; Brøndum, Frøkjer J; Rudolf, Sasa; Bollen, Thomas; Bruno, Marco

    2017-03-01

    There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic pancreatitis across Europe' (HaPanEU) developed these European guidelines using an evidence-based approach. Twelve multidisciplinary review groups performed systematic literature reviews to answer 101 predefined clinical questions. Recommendations were graded using the Grading of Recommendations Assessment, Development and Evaluation system and the answers were assessed by the entire group in a Delphi process online. The review groups presented their recommendations during the 2015 annual meeting of United European Gastroenterology. At this one-day, interactive conference, relevant remarks were voiced and overall agreement on each recommendation was quantified using plenary voting (Test and Evaluation Directorate). After a final round of adjustments based on these comments, a draft version was sent out to external reviewers. The 101 recommendations covered 12 topics related to the clinical management of chronic pancreatitis: aetiology (working party (WP)1), diagnosis of chronic pancreatitis with imaging (WP2 and WP3), diagnosis of pancreatic exocrine insufficiency (WP4), surgery in chronic pancreatitis (WP5), medical therapy (WP6), endoscopic therapy (WP7), treatment of pancreatic pseudocysts (WP8), pancreatic pain (WP9), nutrition and malnutrition (WP10), diabetes mellitus (WP11) and the natural course of the disease and quality of life (WP12). Using the Grading of Recommendations Assessment, Development and Evaluation system, 70 of the 101 (70%) recommendations were rated as 'strong' and plenary voting revealed 'strong agreement' for 99 (98%) recommendations. The 2016 HaPanEU/United European Gastroenterology guidelines provide evidence-based recommendations concerning key aspects

  9. Wheelchair use: a physical sign in gastroenterological practice.

    PubMed

    Chiotakakou-Faliakou, E; Dave, U; Forbes, A

    1996-09-01

    Diagnosis of functional abdominal pain requires exclusion of organic causes, and many patients undergo considerable investigation. A positive physical sign supporting a functional diagnosis could therefore be of benefit. Wheelchair use specifically for abdominal symptoms was suspected to represent such a sign. Review of 300 consecutive new referrals to a gastroenterology clinic revealed 10 wheelchair users. In four women the chair was used because of the abdominal condition. The final diagnosis (with follow-up to at least 12 months) was functional abdominal pain in each of these cases. All four had had surgery without symptom relief, and all had used their chairs intermittently (mainly for social occasions and hospital visits) for at least 12 months. They believed that normal walking was rendered impossible by abdominal pain whereas the other six wheelchair users gave a clear account of lower limb pain or weakness. Secondary gain with reinforcement of the 'sick role' was felt to be the probable explanation for wheelchair use in the former group. Wheelchair attendance at the gastroenterology clinic, in the absence of lower limb symptoms, is a rare observation but one that may usefully be added to criteria for diagnosis of a functional disorder.

  10. 21 CFR 876.4730 - Manual gastroenterology-urology surgical instrument and accessories.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... instrument and accessories. 876.4730 Section 876.4730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT... Devices § 876.4730 Manual gastroenterology-urology surgical instrument and accessories. (a) Identification. A manual gastroenterology-urology surgical instrument and accessories is a device designed to...

  11. 76 FR 71983 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Gastroenterology and Urology Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: Gastroenterology and Urology...

  12. 77 FR 18829 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Gastroenterology and Urology Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: Gastroenterology and Urology...

  13. [Certification of an ambulatory gastroenterologic service fulfilling ISO Law 9001--criteria and national guidelines of the Gastroenterologic Association].

    PubMed

    Birkner, B

    2000-09-01

    The objectives of certification and accreditation are the deployment and examination of quality improvement measures in health care services. The quality management system of the ISO 9001 is created to install measures and tools leading to assured and improved quality in health care. Only some experiences with certification fulfilling ISO 9001 criteria exist in the German health care system. Evidence-based clinical guidelines can serve as references for the development of standards in quality measurement. Only little data exists on the implementation strategy of guidelines and evaluation, respectively. A pilot quality management system in consistence with ISO 9001 criteria was developed for ambulatory, gastroenterological services. National guidelines of the German Society of Gastroenterology and Metabolism and the recommendations of the German Association of Physicians for quality assurance of gastrointestinal endoscopy were included in the documentation and internal auditing. This pilot quality management system is suitable for the first steps in the introduction of quality management in ambulatory health care. This system shows validity for accreditation and certification of gastrointestinal health care units as well.

  14. Do probiotics have a therapeutic role in gastroenterology?

    PubMed Central

    Limdi, Jimmy K; O’Neill, Catherine; McLaughlin, John

    2006-01-01

    Several hundred species of bacteria inhabit the gut, and affect its cell biology, morphology and homeostasis. Many bacteria are however potential pathogens, especially if the integrity of the epithelial barrier is physically or functionally breached. Conversely, the interaction between host and commensal microbes can confer important health benefits. This has led to commercial and public interest in 'probiotics', live microbes principally taken as food supplements. Might probiotics also be used in disease therapy Experimental evidence that probiotics modulate gut physiology, particularly barrier integrity and immunological function, underpins exciting new gastroenterological research. We discuss below the scientific basis for probiotic effects and present a critical perspective for their use in relation to gastrointestinal disease. PMID:17006980

  15. Complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology

    PubMed Central

    Ray, David M; Srinivasan, Indu; Tang, Shou-Jiang; Vilmann, Andreas S; Vilmann, Peter; McCowan, Timothy C; Patel, Akash M

    2017-01-01

    Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient’s work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping and complementary in the management of these complex conditions. PMID:28396724

  16. Patient-reported outcomes in gastroenterology: clinical and research applications.

    PubMed

    Spiegel, Brennan M R

    2013-04-01

    Patient-generated reports, also known as Patient-Reported Outcomes (PROs), capture the patients' illness experience in a structured format and may help bridge the gap between patients and providers. PROs measure any aspect of patient-reported health (e.g., physical, emotional or social symptoms) and can help to direct care and improve clinical outcomes. When clinicians systematically collect patient-reported data in the right place at the right time, PRO measurement can effectively aid in detection and management of conditions, improve satisfaction with care and enhance the patient-provider relationship. This review article summarizes the latest approaches to PRO measuring for clinical trials and clinical practice, with a focus on use of PROs in gastroenterology.

  17. [Notes for the history of pediatric gastroenterology in Peru].

    PubMed

    Álvarez Carrasco, Ricardo Iván

    2015-01-01

    The Pediatric Gastroenterology and Nutrition in Peru, is one of the subspecialties of Pediatrics that has experienced one of the most significant growth in recent decades, however, to achieve this seat it should have passed a long way built through the efforts and talent hundreds of doctors for several generations. Its modern history began in 1981 with the creation of the first unit of the specialty in the National Institute of Child Health (INSN), followed by the establishment of the second specialization that contributed to its spread and progress of several hospitals in the country, and many of them now have a doctor of this specialty. Our purpose is to plant the foundations of that story, whose extension go beyond the space that allows us an article.

  18. Economic evaluations in gastroenterology in Brazil: A systematic review

    PubMed Central

    de Paiva Haddad, Luciana Bertocco; Decimoni, Tassia Cristina; Turri, Jose Antonio; Leandro, Roseli; de Soárez, Patrícia Coelho

    2016-01-01

    AIM: To systematically review economic evaluations in gastroenterology, relating to Brazil, published between 1980 and 2013. METHODS: We selected full and partial economic evaluations from among those retrieved by searching the following databases: MEDLINE (PubMed); Excerpta Medica; the Latin American and Caribbean Health Sciences Literature database; the Scientific Electronic Library Online; the database of the Centre for Reviews and Dissemination; the National Health Service (NHS) Economic Evaluation Database; the NHS Health Technology Assessment database; the Health Economics database of the Brazilian Virtual Library of Health; Scopus; Web of Science; and the Brazilian Network for the Evaluation of Health Technologies. Two researchers, working independently, selected the studies and extracted the data. RESULTS: We identified 535 health economic evaluations relating to Brazil and published in the 1980-2013 period. Of those 535 articles, only 40 dealt with gastroenterology. Full and partial economic evaluations respectively accounted for 23 (57.5%) and 17 (42.5%) of the 40 studies included. Among the 23 full economic evaluations, there were 11 cost-utility analyses, seven cost-effectiveness analyses, four cost-consequence analyses, and one cost-minimization analysis. Of the 40 studies, 25 (62.5%) evaluated medications; 7 (17.5%) evaluated procedures; and 3 (7.5%) evaluated equipment. Most (55%) of the studies were related to viral hepatitis, and most (63.4%) were published after 2010. Other topics included gastrointestinal cancer, liver transplantation, digestive diseases and hernias. Over the 33-year period examined, the number of such economic evaluations relating to Brazil, especially of those evaluating medications for the treatment of hepatitis, increased considerably. CONCLUSION: Further studies are needed in order to ensure that expenditures on health care in Brazil are made as fairly and efficiently as possible. PMID:26855823

  19. Economic evaluations in gastroenterology in Brazil: A systematic review.

    PubMed

    de Paiva Haddad, Luciana Bertocco; Decimoni, Tassia Cristina; Turri, Jose Antonio; Leandro, Roseli; de Soárez, Patrícia Coelho

    2016-02-06

    To systematically review economic evaluations in gastroenterology, relating to Brazil, published between 1980 and 2013. We selected full and partial economic evaluations from among those retrieved by searching the following databases: MEDLINE (PubMed); Excerpta Medica; the Latin American and Caribbean Health Sciences Literature database; the Scientific Electronic Library Online; the database of the Centre for Reviews and Dissemination; the National Health Service (NHS) Economic Evaluation Database; the NHS Health Technology Assessment database; the Health Economics database of the Brazilian Virtual Library of Health; Scopus; Web of Science; and the Brazilian Network for the Evaluation of Health Technologies. Two researchers, working independently, selected the studies and extracted the data. We identified 535 health economic evaluations relating to Brazil and published in the 1980-2013 period. Of those 535 articles, only 40 dealt with gastroenterology. Full and partial economic evaluations respectively accounted for 23 (57.5%) and 17 (42.5%) of the 40 studies included. Among the 23 full economic evaluations, there were 11 cost-utility analyses, seven cost-effectiveness analyses, four cost-consequence analyses, and one cost-minimization analysis. Of the 40 studies, 25 (62.5%) evaluated medications; 7 (17.5%) evaluated procedures; and 3 (7.5%) evaluated equipment. Most (55%) of the studies were related to viral hepatitis, and most (63.4%) were published after 2010. Other topics included gastrointestinal cancer, liver transplantation, digestive diseases and hernias. Over the 33-year period examined, the number of such economic evaluations relating to Brazil, especially of those evaluating medications for the treatment of hepatitis, increased considerably. Further studies are needed in order to ensure that expenditures on health care in Brazil are made as fairly and efficiently as possible.

  20. Use of internet resources by patients awaiting gastroenterology consultation.

    PubMed

    Teriaky, Anouar; Tangri, Vikram; Chande, Nilesh

    2015-01-01

    The purpose of this study is to understand how outpatients awaiting initial gastroenterology consultation seek medical information on the Internet and how wait times affect Internet usage. A cross-sectional survey of 87 gastroenterology outpatients awaiting consultation was performed at a tertiary care center. Fifty-two patients (60%) utilized the Internet for medical information. The mean age of patients using the Internet was 41 years, whereas the mean age of those not using the Internet was 60 years (p<0.0001). The Internet was used by 71% of females and 47% of males (p<0.05). Regarding the educational level, the Internet was sought by 33% of the patients possessing less than secondary school education, 59% possessing secondary school education, 66% with an undergraduate degree, and 100% with a postgraduate degree (p=0.14). The mean wait time for consultation for patients who utilized the Internet was 158 days, and for patients who did not was 147 days (p=0.60). The most common websites searched were medical, 71%. The most common medical information sought was symptoms and diagnosis by 85% of patients. The reasons for Internet use were wait times for 36% of patients and recommendation by a physician for 10%. Eighty seven percent of the patients who utilized the Internet believed that they suffered from an unidentified disease, whereas 46% of patients who did not utilize the Internet believed the same (p=0.0001). Younger patients and females were more likely to use the Internet, but wait times did not affect Internet usage. The Internet is a powerful patient resource; however, further physician guidance is required to help patients identify reliable resources.

  1. White paper of Italian Gastroenterology: delivery of services for digestive diseases in Italy: weaknesses and strengths.

    PubMed

    Buscarini, Elisabetta; Conte, Dario; Cannizzaro, Renato; Bazzoli, Franco; De Boni, Michele; Delle Fave, Gianfranco; Farinati, Fabio; Ravelli, Paolo; Testoni, Pier Alberto; Lisiero, Manola; Spolaore, Paolo

    2014-07-01

    In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999-2009, with more than 1,500,000 admissions/year; however only 5-9% of these admissions was in specialized Gastroenterology units. Reported data show a better outcome in Gastroenterology Units than in non-specialized units: shorter average length of stay, in particular for admissions with ICD-9-CM codes proxying for emergency conditions (6.7 days versus 8.4 days); better case mix (higher average diagnosis-related groups weight in Gastroenterology Units: 1 vs 0.97 in Internal Medicine units and 0.76 in Surgery units); lower inappropriateness of admissions (16-25% versus 29-87%); lower in-hospital mortality in urgent admissions (2.2% versus 5.1%); for patients with urgent admissions due to gastrointestinnal haemorrhage, in-hospital mortality was 2.3% in Gastroenterology units versus 4.0% in others. The present document summarizes the scientific societies' official report, which constitutes the "White paper of Italian Gastroenterology".

  2. Training innovations in gastroenterology and educational resources: a new vision of gastrointestinal education across Europe.

    PubMed

    Berberat, Pascal O; de Wit, Niek J; Bockhorn, Maximilian; Lundell, Lars; Drenth, Joost P H

    2010-12-01

    To define a new educational strategy for the United European Gastroenterology Federation (UEGF) to be followed and implemented in the near future. UEGF organized a consensus-based strategy meeting with stakeholders and key decision makers in European Gastroenterology on Training Innovations in Gastroenterology and Educational Resources. In May 2010, in an 'open-face conference' at Starnberg, Germany, 59 specialists in gastroenterology, hepatology, and related fields from 15 countries and 16 societies participated. Breakout sessions identified the key problem areas, possible solutions, and formulated statements subsequently voted upon in plenum. A majority of the formulated statements (59%) reached a strong agreement. Topics in which UEGF should focus are the future educational activities that include developing ways to advocate multidisciplinarity and integration between levels of care and specialties, ways to improve quality of care, and the development of training tools. The successful outcome of the Training Innovations in Gastroenterology and Educational Resources conference was achieved with the production of a strategy layout for new UEGF educational activities. There was an agreement that improvement in topics related to multidisciplinarity and professionalism, which is crucial for further development. An open-face conference, such as that embodied by the Training Innovations in Gastroenterology and Educational Resources meeting, was shown to be an effective tool in identifying the key problem areas in education and in formulating new strategies.

  3. Food allergy: a practical update from the gastroenterological viewpoint.

    PubMed

    Ferreira, Cristina Targa; Seidman, Ernest

    2007-01-01

    To present an up-to-date and critical review regarding food allergies, focusing mainly on treatment and prevention. Review of published literature searched on MEDLINE database; those data which were the most up-to-date and representative were selected (2000-2006). The search included the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the American Academy of Pediatrics (AAP). The prevalence of allergic diseases has increased over the last decades, and food allergy seems to be part of this increase. Food allergy is much more common in pediatrics and has a significant medical, financial and social impact on young children and their families. Treatment and prevention of food allergy is a major challenge for public health, scientific and medical communities. There is a lot of misinformation and the medical management of this condition is still discussable. We present and discuss the guidelines regarding criteria for the prevention of food allergy and atopic diseases published by the Nutrition Committees of ESPGHAN jointly with the European Society for Pediatric Allergy and Clinical Immunology (ESPACI) and AAP. The overdiagnosis of food allergy is quite prevalent. There is a need for standardization of definitions and diagnostic procedures. The primary goal of therapy should be to first establish effective means of preventing food allergies. There is a need for accurate diagnostic methods to confirm or rule out the diagnosis. Patients need appropriate treatment by eliminating foods that cause symptoms, while avoiding the nutritional side effects and the cost of inappropriate diets.

  4. Gastroenterology training in private hospitals: India vs South Africa

    PubMed Central

    Mulder, Chris Jacob Johan; Puri, Amarender Singh; Reddy, Duvvur Nageshwar

    2010-01-01

    In South Africa, nurses and doctors are emigrating in significant numbers. Job satisfaction, safety and ensuring career progression are important in retaining doctors to make a career in Republic of South Africa (RSA). Due to budgetary constraints many hospitals have not been upgraded. Coming home after overseas training seems difficult. In RSA it takes a minimum of 13 years for a young specialist to become registered and 15 years for subspecialists. Career progression, creating more specialist trainees in public and private hospitals and shortening the period of professional training are potential solutions to the problem. India, which has a population of more than 1 billion people, is struggling with similar problems. For the past 10-15 years, private hospitals have assisted in manpower development for medical specialist and subspecialist careers. Currently their private sector trains 60% of their recognised (sub)specialities fellows. A national task force for specialist training in RSA should be instituted. It should discuss, based on the current status and projected specialist and subspecialist personnel requirements, the future structure and logistics of training needs. This is required in all subspecialities including gastroenterology, as has been done in India. It is hoped that as a consequence well-trained doctors, similar to those in India, might move to provincial hospitals in rural areas, upgrading the medical services and keeping medical power in South Africa. South Africa should become a model for Sub-Saharan Africa, as India already is for South-East Asia. PMID:20180232

  5. Advances of molecular clinical pharmacology in gastroenterology and hepatology.

    PubMed

    Prandota, Joseph

    2010-01-01

    During developmental age, differences in pharmacodynamic reactions to several drugs may reflect polymorphisms of genes encoding drug-transporting proteins, receptors, drug targets, and gene products, whose disturbed activity sometimes plays an important role in certain diseases. Administration of drugs with a narrow therapeutic index may quite easily be associated with changes in pharmacokinetics and development of adverse drug reactions, which occasionally may cause fatalities. In such cases, polypragmasy and resulting drug interactions may enhance effects of changes in drug-metabolizing enzymes' activities. Phenotyping and genotyping of patients slowly are finding their place in some therapeutic regimens used in clinical gastroenterology and hepatology. At present, some assays to measure, for example, thiopurine S-methyltransferase activity are already commercially available. Polymorphisms of CYP450 enzymes, interleukins, and altered gene expression play an important role in some patients' various gastrointestinal tract and liver diseases. Herbal drugs also affect proinflammatory and antiinflammatory cytokine and nitric oxide balance in the body. Therapeutic use of recombined proteins, such as infliximab, natalizumab, onercept, humanized antibody to integrin α-4 β-7, or IFN-β in some large-bowel diseases increased therapeutic efficacy. IFN-α used in the patients with chronic hepatitis C improved cellular immunity in these subjects and exerted antiviral activity. Practical application of progress in pharmacogenetics, pharmacokinetics, pharmacodynamics, and use of bioproducts in novel therapeutic regimens has opened therapeutic frontiers and increased clinical safety.

  6. The ‘natural history’ of declined outpatient gastroenterology referrals

    PubMed Central

    de Boer, Emelie M; Pincock, David; Veldhuyzen van Zanten, Sander

    2012-01-01

    OBJECTIVE: To evaluate the ‘natural history’ of outpatients who were referred to the Division of Gastroenterology at the University of Alberta Hospital (Edmonton, Alberta) for gastrointestinal problems and were subsequently declined. METHODS: Patients were tracked for 12 months after they were referred and declined for the following indications: abdominal pain, rectal bleeding, fecal occult blood test-positive stools and iron deficiency. For each patient, data regarding consultations by other gastroenterologists or surgeons working in the region, clinically relevant diagnoses and the number of gastrointestinal-related x-rays performed were obtained. RESULTS: Of a total sample size of 230 patients, 110 (47.8%) were seen by another gastroenterologist or surgeon after decline. A significant diagnosis was made in 21 patients (9.1%), which had immediate clinical consequences in 29%. Forty per cent of patients underwent one or more gastointestinal-related x-rays before being declined, which increased to 55% after decline. CONCLUSION: Approximately 50% of declined patients were seen by other gastroenterologists or surgeons in the region. In 9.1% of these patients, a clinically important diagnosis was made, of which one-quarter had immediate medical consequences. PMID:23166900

  7. Ultrahigh speed endoscopic optical coherence tomography for gastroenterology

    PubMed Central

    Tsai, Tsung-Han; Lee, Hsiang-Chieh; Ahsen, Osman O.; Liang, Kaicheng; Giacomelli, Michael G.; Potsaid, Benjamin M.; Tao, Yuankai K.; Jayaraman, Vijaysekhar; Figueiredo, Marisa; Huang, Qin; Cable, Alex E.; Fujimoto, James; Mashimo, Hiroshi

    2014-01-01

    We describe an ultrahigh speed endoscopic swept source optical coherence tomography (OCT) system for clinical gastroenterology using a vertical-cavity surface-emitting laser (VCSEL) and micromotor imaging catheter. The system had a 600 kHz axial scan rate and 8 µm axial resolution in tissue. Imaging was performed with a 3.2 mm diameter imaging catheter at 400 frames per second with a 12 µm spot size. Three-dimensional OCT (3D-OCT) imaging was performed in patients with a cross section of pathologies undergoing upper and lower endoscopy. The use of distally actuated imaging catheters enabled OCT imaging with more flexibility, such as volumetric imaging in the small intestine and the assessment of hiatal hernia using retroflex imaging. The high rotational scanning stability of the micromotor enabled 3D volumetric imaging with micron scale volumetric accuracy for both en face OCT and cross-sectional imaging, as well as OCT angiography (OCTA) for 3D visualization of subsurface microvasculature. The ability to perform both structural and functional 3D OCT imaging in the GI tract with microscopic accuracy should enable a wide range of studies and enhance the sensitivity and specificity of OCT for detecting pathology. PMID:25574446

  8. Assessing cultural competency skills in gastroenterology fellowship training

    PubMed Central

    Balzora, Sophie; Abiri, Benjamin; Wang, Xiao-Jing; McKeever, James; Poles, Michael; Zabar, Sondra; Gillespie, Colleen; Weinshel, Elizabeth

    2015-01-01

    AIM: To assess and teach cultural competency skills at the fellowship training level through the use of objective structured clinical examinations (OSCEs). METHODS: We revised four scenarios to infuse a specific focus on cross-cultural care, and to render them appropriate for gastroenterology fellows. Three are discussed here: (1) Poor Health Literacy; (2) Disclosing/Apologizing for a Complication to a Patient Who Mistrusts the Healthcare System; and (3) Breaking Bad News to a Fatalistic Patient. A fourth case emphasizing shared decision-making will be described elsewhere. Four stations were completed by fellows and observed live by four faculty members, and the fellows’ performance was assessed. RESULTS: Eleven fellows from four programs participated in the four OSCE. In the “Poor Health Literacy” case, 18% (2/11) of participants recognized that the standardized patient (SP) had below-basic health literacy. None successfully evaluated the SP’s reading skills in a culturally-sensitive manner. In “Disclosing/Apologizing for a Complication”, 4/11 (36%) personally apologized for the complication. 1/11 recognized the SP’s mistrust of the medical system. With “Breaking Bad News”, 27% (3/11) explored the patient’s values to identify her fatalistic beliefs. CONCLUSION: OSCEs can be used to assess deficiencies in culturally-competent care at the fellowship level. OSCEs also afford fellowships the opportunity to inform future training curricula. PMID:25684956

  9. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU)

    PubMed Central

    Dominguez-Munoz, Enrique; Rosendahl, Jonas; Besselink, Marc; Mayerle, Julia; Lerch, Markus M; Haas, Stephan; Akisik, Fatih; Kartalis, Nikolaos; Iglesias-Garcia, Julio; Keller, Jutta; Boermeester, Marja; Werner, Jens; Dumonceau, Jean-Marc; Fockens, Paul; Drewes, Asbjorn; Ceyhan, Gürlap; Lindkvist, Björn; Drenth, Joost; Ewald, Nils; Hardt, Philip; de Madaria, Enrique; Witt, Heiko; Schneider, Alexander; Manfredi, Riccardo; Brøndum, Frøkjer J; Rudolf, Sasa; Bollen, Thomas; Bruno, Marco

    2017-01-01

    Background There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on ‘Harmonizing diagnosis and treatment of chronic pancreatitis across Europe’ (HaPanEU) developed these European guidelines using an evidence-based approach. Methods Twelve multidisciplinary review groups performed systematic literature reviews to answer 101 predefined clinical questions. Recommendations were graded using the Grading of Recommendations Assessment, Development and Evaluation system and the answers were assessed by the entire group in a Delphi process online. The review groups presented their recommendations during the 2015 annual meeting of United European Gastroenterology. At this one-day, interactive conference, relevant remarks were voiced and overall agreement on each recommendation was quantified using plenary voting (Test and Evaluation Directorate). After a final round of adjustments based on these comments, a draft version was sent out to external reviewers. Results The 101 recommendations covered 12 topics related to the clinical management of chronic pancreatitis: aetiology (working party (WP)1), diagnosis of chronic pancreatitis with imaging (WP2 and WP3), diagnosis of pancreatic exocrine insufficiency (WP4), surgery in chronic pancreatitis (WP5), medical therapy (WP6), endoscopic therapy (WP7), treatment of pancreatic pseudocysts (WP8), pancreatic pain (WP9), nutrition and malnutrition (WP10), diabetes mellitus (WP11) and the natural course of the disease and quality of life (WP12). Using the Grading of Recommendations Assessment, Development and Evaluation system, 70 of the 101 (70%) recommendations were rated as ‘strong' and plenary voting revealed ‘strong agreement' for 99 (98%) recommendations. Conclusions The 2016 HaPanEU/United European Gastroenterology guidelines provide

  10. Coeliac disease screening is suboptimal in a tertiary gastroenterology setting.

    PubMed

    Iskandar, Heba; Gray, Darrell M; Vu, Hongha; Mirza, Faiz; Rude, Mary Katherine; Regan, Kara; Abdalla, Adil; Gaddam, Srinivas; Almaskeen, Sami; Mello, Michael; Marquez, Evelyn; Meyer, Claire; Bolkhir, Ahmed; Kanuri, Navya; Sayuk, Gregory; Gyawali, C Prakash

    2017-08-01

    Coeliac disease (CD) is widely prevalent in North America, but case-finding techniques currently used may not be adequate for patient identification. We aimed to determine the adequacy of CD screening in an academic gastroenterology (GI) practice. Consecutive initial visits to a tertiary academic GI practice were surveyed over a 3-month period as a fellow-initiated quality improvement project. All electronic records were reviewed to look for indications for CD screening according to published guidelines. The timing of screening was noted (before or after referral), as well as the screening method (serology or biopsy). Data were analysed to compare CD screening practices across subspecialty clinics. 616 consecutive patients (49±0.6 years, range 16-87 years, 58.5% females, 94% Caucasian) fulfilled inclusion criteria. CD testing was indicated in 336 (54.5%), but performed in only 145 (43.2%). The need for CD screening was highest in luminal GI and inflammatory bowel disease clinics, followed by biliary and hepatology clinics (p<0.0001); CD screening rate was highest in the luminal GI clinic (p=0.002). Of 145 patients screened, 4 patients (2.4%) had serology consistent with CD, of which 2 were proven by duodenal biopsy. Using this proportion, an additional 5 patients might have been diagnosed in 191 untested patients with indications for CD screening. More than 50% of patients in a tertiary GI clinic have indications for CD screening, but <50% of indicated cases are screened. Case-finding techniques therefore are suboptimal, constituting a gap in patient care and an important target for future quality improvement initiatives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Female authorship in major academic gastroenterology journals: a look over 20 years.

    PubMed

    Long, Michelle T; Leszczynski, Ania; Thompson, Katherine D; Wasan, Sharmeel K; Calderwood, Audrey H

    2015-01-01

    Authorship in peer-reviewed medical journals is a marker for success in academic medicine. To determine the representation of female physicians among authors of original research in U.S. gastroenterology journals. Retrospective. All first and senior U.S. authors of original research published in the years 1992, 1997, 2002, 2007, and 2012 in the following journals: Gastroenterology, Hepatology, American Journal of Gastroenterology, Clinical Gastroenterology and Hepatology (CGH), and Gastrointestinal Endoscopy (GIE). The percentage of female first and senior authors compared with the percentage of women practicing in academic gastroenterology. We evaluated 6490 articles, of which 2275 original research articles and 455 editorials were eligible for inclusion. Author gender was determined for 98.5% of the 3792 authors. Overall, female first authors increased from 9.1±2.9% in 1992 to 29.3±4.9% in 2012 (P<.0001), and female senior authors increased from 4.8±2.3% in 1992 to 14.5±3.6% in 2012 (P<.0001). Female first and senior authors increased significantly in all journals (P for trend<.05), except for CGH, and CGH and GIE, respectively. For each of the years examined with the exception of 1997, the proportion of women in the senior author position was less than expected based on the proportion of women among academic gastroenterologists (P<.004; P=.18 for 1997). Descriptive study. The percentage of U.S. female physician authors of original research in major gastroenterology journals has increased over time, yet the percentage of women in the senior author position remains lower than expected. Further research should explore potential reasons for this gender gap. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  12. Funding source and conflict of interest disclosures by authors and editors in gastroenterology specialty journals revisited.

    PubMed

    Qureshi, J; Sud, A; Vakil, N

    2012-03-01

    A survey of journals published in the field of Gastroenterology conducted 5 years ago showed marked variability in reporting of conflicts of interest or funding sources in these journals. To re-examine reporting of conflicts of interest and funding sources for original articles and editorials in Gastroenterology and Hepatology journals. We evaluated all original articles and editorials in 15 leading journals (determined by impact factor-Thomson Reuter Science Citation Index) devoted to Gastroenterology and Hepatology for disclosures of conflicts and for editor's self disclosures. We examined each journal's editorial policy by contacting the journal directly if the information was not revealed on the Web site or print versions of the journal. Of the 1574 articles evaluated, a total of 1207 (77%) reported the presence or absence of a potential conflict of interest and 1047 (67%) reported the presence or absence of funding sources. A total of 3 of the 15 (20%) journals (American Journal of Gastroenterology, Gastroenterology, and Alimentary Pharmacology and Therapeutics reported the presence or absence of funding sources in all their published original articles. Only 5 of 15 (33%) journals (Gut, Gastrointestinal Endoscopy, American Journal of Gastroenterology, Neurogastroenterology & Motility and Alimentary Pharmacology and Therapeutics) publicly disclosed the conflicts of interest of the editors. (i) Funding sources and conflicts of interest are still reported variably in the GI literature. (ii) Editorials and review articles are influential, but have poor reporting of conflicts of interest. (iii) Editors of many journals still do not report their conflicts of interest. © 2012 Blackwell Publishing Ltd.

  13. 78 FR 41937 - Joint Meeting of the Gastroenterology-Urology Panel and the Radiological Devices Panel of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-12

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Joint Meeting of the Gastroenterology-Urology Panel and the... the public. Name of Committee: Gastroenterology-Urology Panel and Radiological Devices Panel of the...

  14. Resident trainees do not affect patient satisfaction in an outpatient gastroenterology clinic: A prospective study conducted in a Canadian gastroenterology clinic

    PubMed Central

    Brahmania, Mayur; Young, Madison; Muthiah, Chetty; Ilnyckyj, Alexandra; Duerksen, Donald; Moffatt, Dana C

    2015-01-01

    BACKGROUND: There is little literature regarding how a gastroenterology trainee affects a patient’s interpretation of care during outpatient clinic visits. Improving patient satisfaction is desirable and benefits may include enhanced patient compliance as well as providing trainees with areas for improvement. OBJECTIVES: To evaluate patient satisfaction in an outpatient gastroenterology clinic when seen by a trainee and attending physician versus an attending physician alone. The secondary objective was to evaluate physician characteristics that play a role in creating a positive clinical experience. METHODS: A randomized prospective survey study was conducted over an 11-month period (July 2012 to June 2013) at St Boniface Hospital (Winnipeg, Manitoba). Two gastroenterology fellows (postgraduate year 4 and 5) and nine internal medicine residents (postgraduate year 1 to 3) comprised the ‘trainee’ role, while three academic clinicians comprised the ‘attending’ role. Patients included individuals seen for an initial consultation and were >18 years of age. RESULTS: A total of 211 patients comprised the final study group, with 118 in the attending group and 93 in the trainee group. In univariate analysis, patients more often had a very good experience when seen by an attending physician alone versus a trainee and attending physician (73% versus 56%; P=0.016); however, on multivariate analysis, there was no significant difference in patient satisfaction (OR 0.89; P=0.931). Physician factors found to be associated with high patient satisfaction on multivariate analysis included: addressing all patient concerns (OR 27.56; P=0.021); giving the patient a preliminary diagnosis (OR 78.02; P=0.006); and feeling the physician was thorough (OR 72.53; P=0.029). CONCLUSIONS: The present study did not reveal a difference in patient satisfaction if a patient sees an attending physician alone or with a trainee. Moreover, to improve patient satisfaction in a gastroenterology

  15. Resident trainees do not affect patient satisfaction in an outpatient gastroenterology clinic: a prospective study conducted in a Canadian gastroenterology clinic.

    PubMed

    Brahmania, Mayur; Young, Madison; Muthiah, Chetty; Ilnyckyj, Alexandra; Duerksen, Donald; Moffatt, Dana C

    2015-10-01

    There is little literature regarding how a gastroenterology trainee affects a patient's interpretation of care during outpatient clinic visits. Improving patient satisfaction is desirable and benefits may include enhanced patient compliance as well as providing trainees with areas for improvement. To evaluate patient satisfaction in an outpatient gastroenterology clinic when seen by a trainee and attending physician versus an attending physician alone. The secondary objective was to evaluate physician characteristics that play a role in creating a positive clinical experience. A randomized prospective survey study was conducted over an 11-month period (July 2012 to June 2013) at St Boniface Hospital (Winnipeg, Manitoba). Two gastroenterology fellows (postgraduate year 4 and 5) and nine internal medicine residents (postgraduate year 1 to 3) comprised the 'trainee' role, while three academic clinicians comprised the 'attending' role. Patients included individuals seen for an initial consultation and were >18 years of age. A total of 211 patients comprised the final study group, with 118 in the attending group and 93 in the trainee group. In univariate analysis, patients more often had a very good experience when seen by an attending physician alone versus a trainee and attending physician (73% versus 56%; P=0.016); however, on multivariate analysis, there was no significant difference in patient satisfaction (OR 0.89; P=0.931). Physician factors found to be associated with high patient satisfaction on multivariate analysis included: addressing all patient concerns (OR 27.56; P=0.021); giving the patient a preliminary diagnosis (OR 78.02; P=0.006); and feeling the physician was thorough (OR 72.53; P=0.029). The present study did not reveal a difference in patient satisfaction if a patient sees an attending physician alone or with a trainee. Moreover, to improve patient satisfaction in a gastroenterology clinic, physicians should address all patient concerns, provide a

  16. General medical training in gastroenterology: views from specialist trainees on the challenges of dual accreditation.

    PubMed

    Neale, James R; Basford, Peter J

    2015-02-01

    Higher specialist training in general internal medicine (GIM) and the medical specialties has been subject to many changes and increasing subspecialisation in recent years. The 'Shape of Training' review proposes 'broad-based specialty training', shortening of training by one year, and subspecialisation to be undertaken after the certificate of specialty training is obtained. All higher level gastroenterology trainees based in the UK were invited to complete an online survey between July and September 2012 to assess their experience of gastroenterology and GIM training. Overall, 72.7% of trainees expressed satisfaction with their training in gastroenterology but significantly fewer (43.5%) expressed satisfaction with their training in GIM. Satisfaction with gastroenterology training thus is good, but satisfaction with GIM training is lower and levels of dissatisfaction have increased significantly since 2008. Up to 50% of trainees are not achieving the minimum recommended number of colonoscopy procedures for their stage of training. Experience in GIM is seen as service orientated, with a lack of training opportunities. There is a worrying difficulty in gaining the minimum required experience in endoscopy. If the length of specialist training is shortened and generalised, training in key core specialist skills such as endoscopy may be compromised further. © 2015 Royal College of Physicians.

  17. Nutrition education for pediatric gastroenterology, hepatology, and nutrition fellows: survey of NASPGHAN fellowship training programs.

    PubMed

    Martinez, J Andres; Koyama, Tatsuki; Acra, Sari; Mascarenhas, Maria R; Shulman, Robert J

    2012-08-01

    The aim of the study was to assess the methodology and content of nutrition education during gastroenterology fellowship training and the variability among the different programs. A survey questionnaire was completed by 43 fellowship training directors of 62 active programs affiliated to the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition, including sites in the United States, Canada, and Mexico. The data were examined for patterns in teaching methodology and coverage of specific nutrition topics based on level 1 training in nutrition, which is the minimum requirement according to the published North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition fellowship training guidelines. The majority of the teaching was conducted by MD-degree faculty (61%), and most of the education was provided through clinical care experiences. Only 31% of the level 1 nutrition topics were consistently covered by >80% of programs, and coverage did not correlate with the size of the programs. Competency in nutrition training was primarily assessed through questions to individuals or groups of fellows (77% and 65%, respectively). Program directors cited a lack of faculty interested in nutrition and a high workload as common obstacles for teaching. The methodology of nutrition education during gastroenterology fellowship training is, for the most part, unstructured and inconsistent among the different programs. The minimum level 1 requirements are not consistently covered. The development of core curriculums and learning modules may be beneficial in improving nutrition education.

  18. American Gastroenterological Association Institute technical review on the management of gastric subepithelial masses.

    PubMed

    Hwang, Joo Ha; Rulyak, Stephen D; Kimmey, Michael B

    2006-06-01

    This literature review and the recommendations therein were prepared for the American Gastroenterological Association Institute Clinical Practice and Economics Committee. The paper was approved by the Committee on January 19, 2006, and by the AGA Institute Governing Board on April 20, 2006.

  19. American Gastroenterological Association Institute medical position statement on the management of gastric subepithelial masses.

    PubMed

    2006-06-01

    This document presents the official recommendations of the American Gastroenterological Association Institute (AGA Institute) on "Management of Gastric Subepithelial Masses." It was approved by the Clinical Practice and Economics Committee on January 19, 2006, and by the AGA Institute Governing Board on April 20, 2006.

  20. 75 FR 57968 - Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-23

    ... HUMAN SERVICES Food and Drug Administration Gastroenterology and Urology Devices Panel of the Medical... PMA for the LAP-BAND Adjustable Gastric Banding System, sponsored by Allergan. The sponsor is requesting an expanded Indication for Use for their LAP-BAND Adjustable Gastric Banding System to include...

  1. Nutrition education for pediatric gastroenterology, hepatology, and nutrition fellows: Survey of NASPGHAN fellowship training programs

    USDA-ARS?s Scientific Manuscript database

    The aim of the study was to assess the methodology and content of nutrition education during gastroenterology fellowship training and the variability among the different programs. A survey questionnaire was completed by 43 fellowship training directors of 62 active programs affiliated to the North A...

  2. A quantitative readability analysis of patient education resources from gastroenterology society websites.

    PubMed

    Hansberry, David R; Patel, Sahil R; Agarwal, Prateek; Agarwal, Nitin; John, Elizabeth S; John, Ann M; Reynolds, James C

    2017-06-01

    The lay public frequently access and rely on online information as a source of their medical knowledge. Many medical societies are unaware of national patient education material guidelines and subsequently fail to meet them. The goal of the present study was to evaluate the readability of patient education materials within the medical field of gastroenterology. Two hundred fourteen articles pertaining to patient education materials were evaluated with ten well-established readability scales. The articles were available on the websites for the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), the American Society of Gastrointestinal Endoscopy (ASGE), the British Society of Gastroenterology (BSG), and the NIH section National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). One-way analysis of variance (ANOVA) and Tukey's honest significant difference (HSD) post hoc analysis were conducted to determine any differences in level of readability between websites. The 214 articles were written at an 11.8 ± 2.1 grade level with a range of 8.0 to 16.0 grade level. A one-way ANOVA and Tukey's HSD post hoc analysis determined the ACG was written at a significantly (p < 0.05) more difficult level when compared to the AGA, the BSG, and the NIDDK websites. No differences were noted when comparing the ASGE website. None of the patient education materials were written at a level that met national guidelines. If the materials are redrafted, the general American public will likely have a greater understanding of the gastroenterology content.

  3. The 50 Most-cited Articles in Gastroenterology and Hepatology from Mainland China.

    PubMed

    Hu, Sun-Kuan; Huang, Jie; Hong, Wan-Dong; Du, Xiao-Jing; Jin, Rong; Lin, Tie-Su

    2017-01-01

    To identify and analyze the 50 most-cited gastroenterology and hepatology articles originating from mainland China. We utilized the 2015 edition of Journal Citation Reports and PubMed to determine the 50 most-cited gastroenterology and hepatology articles from 75 professional journals and four leading journals in clinical medicine, which are The New England Journal of Medicine, The Lancet, The Journal of the American Medical Association, and The British Medical Journal. Then we excluded the articles written outside mainland China and collected the basic information, including the title, authors, year of publication, source journal, city, institution, number of citations, and topic of the research. The number of citations for the top 50 papers ranged from 279 to 89 (mean, 129). These articles were published between 2005 and 2012, in which 2009 was the year with the largest number of highly cited papers(13). All articles were published in 15 journals. The journal Hepatology published the largest number of articles(21), followed by Journal of Gastroenterology and Hepatology(4), Journal of Hepatology(4) and World Journal of Gastroenterology(4). The top 50 articles originated mainly from Shanghai(20), Guangzhou(13) and Beijing(6). Sun Yat-sen University produced most highly cited papers(10). The number of basic research was far more than clinical research, of which the ratio was about 1.78(32:18). In all these articles, hepatocellular carcinoma was the most-discussed topic(19), followed by hepatitis B virus(8) and endoscopic(5). Although a large gap remains between mainland China and the global community, the gastroenterology and hepatology research from China is gradually recognized by the world.

  4. Quality of meta-analyses in major leading gastroenterology and hepatology journals: A systematic review.

    PubMed

    Liu, Pengfei; Qiu, Yuanyu; Qian, Yuting; Chen, Xiao; Wang, Yiran; Cui, Jin; Zhai, Xiao

    2017-01-01

    To appraise the current reporting methodological quality of meta-analyses in five leading gastroenterology and hepatology journals, and to identify the variables associated with the reporting quality. We systematically searched the literature of meta-analyses in Gastroenterology, Gut, Hepatology, Journal of Hepatology (J HEPATOL) and American Journal of Gastroenterology (AM J GASTROENTEROL) from 2006 to 2008 and from 2012 to 2014. Characteristics were extracted based on the PRISMA statement and the AMSTAR tool. Country, number of patients, funding source were also revealed and descriptively reported. A total of 127 meta-analyses were enrolled in this study and were compared among journals, study years, and other characters. Compliances with the PRISMA statement and the AMSTAR checklist were 20.8 ± 4.2 out of a maximum of 27 and 7.6 ± 2.4 out of a maximum of 11, respectively. Some domains were poorly reported including describing a protocol and/or registration (item 5, 0.0%), describing methods, and giving results of additional analyses (item 16, 45.7% and item 23, 48.0%) for PRISMA and duplicating study selection and data extraction (item 2, 53.5%), and providing a list of included and excluded studies (item 5, 14.2%) for AMSTAR. Publication in recent years showed a significantly better methodological quality than those published in previous years. This study shows that methodological reporting quality of MAs in the major gastroenterology and hepatology journals has improved in recent years after the publication of the developed PRISMA statement, and it can be further improved. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  5. The 50 Most-cited Articles in Gastroenterology and Hepatology from Mainland China

    PubMed Central

    Hu, Sun-kuan; Huang, Jie; Hong, Wan-dong; Du, Xiao-jing; Jin, Rong; Lin, Tie-su

    2017-01-01

    Objective: To identify and analyze the 50 most-cited gastroenterology and hepatology articles originating from mainland China. Methods: We utilized the 2015 edition of Journal Citation Reports and PubMed to determine the 50 most-cited gastroenterology and hepatology articles from 75 professional journals and four leading journals in clinical medicine, which are The New England Journal of Medicine, The Lancet, The Journal of the American Medical Association, and The British Medical Journal. Then we excluded the articles written outside mainland China and collected the basic information, including the title, authors, year of publication, source journal, city, institution, number of citations, and topic of the research. Results: The number of citations for the top 50 papers ranged from 279 to 89 (mean, 129). These articles were published between 2005 and 2012, in which 2009 was the year with the largest number of highly cited papers(13). All articles were published in 15 journals. The journal Hepatology published the largest number of articles(21), followed by Journal of Gastroenterology and Hepatology(4), Journal of Hepatology(4) and World Journal of Gastroenterology(4). The top 50 articles originated mainly from Shanghai(20), Guangzhou(13) and Beijing(6). Sun Yat-sen University produced most highly cited papers(10). The number of basic research was far more than clinical research, of which the ratio was about 1.78(32:18). In all these articles, hepatocellular carcinoma was the most-discussed topic(19), followed by hepatitis B virus(8) and endoscopic(5). Conclusions: Although a large gap remains between mainland China and the global community, the gastroenterology and hepatology research from China is gradually recognized by the world. PMID:28367203

  6. Molecular Biology and Functions of Carrier Proteins. Annual Symposium (46th) of the Society of General Physiologists held in Woods Hole, Massachusetts on September 10-13, 1992. Volume 48

    DTIC Science & Technology

    1993-09-13

    Beckwith. 1989. Genetic studies on the inabilitv of beta -galactosidase to be translocated across thc E. coli cytoplasmic membrane. Journal of Bactenoloi...downstream of motif A at positions 542 and 1186. The A motif is believed to form a flexible loop between a beta strand and an alpha helix. Through...E. W. Nester. 1989. Role of Agrobacterium rumefaciens ChvA protein in export of p3-1.2- glucan . Journal of Bacteriol- ogy. 171:1609-1615. Chaudhary, P

  7. Legal Issues in Education Practice: Challenges and Opportunities in the 21st Century. Papers [of the] Education Law Association Annual Conference (46th, Atlanta, Georgia, November 9-11, 2000). Topic Outlines.

    ERIC Educational Resources Information Center

    Education Law Association, Dayton, OH.

    This document contains the conference papers of the Education Law Association's 2000 conference. The papers examine school prayer; student speech under the Equal Access Act; the control of student behavior and expression; legal challenges facing the charter-school movement, the future of special-education law, school desegregation decrees, and…

  8. Regenerative medicine technology applied to gastroenterology: current status and future perspectives.

    PubMed

    Orlando, Giuseppe

    2012-12-21

    This special issue of World Journal of Gastroenterology has been conceived to illustrate to gastroenterology operators the role that regenerative medicine (RM) will have in the progress of gastrointestinal (GI) medicine. RM is a multidisciplinary field aiming to replace, regenerate or repair diseased tissues or organs. The past decade has been marked by numerous ground-breaking achievements that led experts in the field to manufacture functional substitutes of relatively simple organs. This progress is paving the ground for investigations that aims to the bioengineering and regeneration of more complex organs like livers, pancreas and intestine. In this special issue, the reader will be introduced, hand-in-hand, to explore the field of RM and will be educated on the progress, pitfalls and promise of RM technologies as applied to GI medicine.

  9. Journals in surgery and gastroenterology: indexing in databases and bibliometric indicators.

    PubMed

    Castro, Regina C Figueiredo

    2006-01-01

    Publishing research results as journal articles is the most common format used by researchers for dissemination of advancements in science. To select where to publish, authors must know how to identify the most recognized journals in each field, adopting quality criteria. To discuss journal selection criteria and bibliometric indicators for evaluation of scientific production and to analyze the status of indexing of Brazilian and international journals in health science databases, mainly for journals in surgery and gastroenterology fields. The totals of journals indexed in health science databases are presented, highlighting the relative participation of journals in surgery and gastroenterology in each database. The decision to publish in a national or international journal should be based on bibliometric indicators and status of indexing in databases, but the objectives of the research must be the main point considered by authors.

  10. The past 10 years of gastroenterology and hepatology-reflections and predictions.

    PubMed

    Friedman, Scott L; Quigley, Eamonn M M; Sharkey, Keith A; Sung, Joseph J Y; Whitcomb, David C

    2014-11-01

    In November 2004, the very first issue of this journal featured articles on the pathogenesis of ulcerative colitis, mechanisms leading to chronic pancreatitis, and treatment of recurrent Clostridium-difficile-associated diarrhoea. Although those topics might seem familiar, much has changed in the intervening years in our understanding, diagnosis and treatment of many different diseases across the field of gastroenterology and hepatology. Nonetheless, many challenges remain. Here, we have asked five of our Advisory Board members-international experts across different subspecialties in gastroenterology and hepatology-to reflect on the progress and frustrations of the past 10 years. They also comment on where effort and money should be invested now, as well as their predictions for progress in the next 10 years.

  11. Development of gastroenterology and hepatology in Iran: Part II- advances in research and therapeutic modalities.

    PubMed

    Saberifiroozi, Mehdi; Mir-Madjlessi, Seid-Hossein

    2009-09-01

    Following the establishment of Gastroenterology and Hepatology Fellowship Programs in 1987, significant developments in research and health care delivery have been achieved. The number of published articles has increased significantly and now more than 10 approved research centers are involved in several longitudinal and population based studies in GI epidemiology, viral hepatitis and GI oncology around the country. Before 1987 less than 50 gastroenterologists were working in the country, but now more than 300 gastroenterologists are involved in public and private health care delivery systems. Advanced diagnostic and therapeutic endoscopic procedures and complex surgical procedures such as liver transplantation are a routine now. These achievements are indicative of hard work and determination of dedicated physicians after the Islamic Revolution, and the support of governmental and non-governmental sectors. The future prospect of development in the discipline of gastroenterology and hepatology in Iran seems to be very encouraging.

  12. Increasing complexity of clinical research in gastroenterology: implications for the training of clinician-scientists.

    PubMed

    Scott, Frank I; McConnell, Ryan A; Lewis, Matthew E; Lewis, James D

    2012-04-01

    Significant advances have been made in clinical and epidemiologic research methods over the past 30 years. We sought to demonstrate the impact of these advances on published gastroenterology research from 1980 to 2010. Twenty original clinical articles were randomly selected from each of three journals from 1980, 1990, 2000, and 2010. Each article was assessed for topic, whether the outcome was clinical or physiologic, study design, sample size, number of authors and centers collaborating, reporting of various statistical methods, and external funding. From 1980 to 2010, there was a significant increase in analytic studies, clinical outcomes, number of authors per article, multicenter collaboration, sample size, and external funding. There was increased reporting of P values, confidence intervals, and power calculations, and increased use of large multicenter databases, multivariate analyses, and bioinformatics. The complexity of clinical gastroenterology and hepatology research has increased dramatically, highlighting the need for advanced training of clinical investigators.

  13. Ordinary tales from endoscopic odysseys: fiction, ethics, and the gastroenterological journey.

    PubMed

    Meulenberg, Frans; de Beaufort, Inez D

    2014-04-01

    Fiction (i.e. novels, short stories, and movies) provides an opportunity for imaginative moral reflection and can serve as a basis for moral argument. Narratives play a role in moral reasoning because they are exemplars as well as tests. Those who care for sick people, should be interested in patient's and literary stories. Exploring the representation of gastroenterological ailments in fiction gives insight in the experience of undergoing colonoscopy, farting, pain, the borders of intimacy, hygiene and the lack of it, taboos and the doctor-patient-relationship. Included authors are, among others: Michel Faber, Alan Bennett, Charles Bukowski, Charlotte Roche and James Joyce. Several movies are discussed as well. Though in general gastroenterological problems don't seem often at foreground in fiction, in some cases they are represented in a more symbolic way, and touch upon some fundamental aspects of the human condition. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Graduate Medical Education in Humanism and Professionalism: A Needs Assessment Survey of Pediatric Gastroenterology Fellows

    PubMed Central

    Garvey, Katharine C.; Kesselheim, Jennifer C.; Herrick, Daniel B.; Woolf, Alan D.; Leichtner, Alan M.

    2014-01-01

    The deterioration of humanism and professionalism during graduate medical training is an acknowledged concern, and programs are required to provide professionalism education for pediatric fellows. We conducted a needs assessment survey in a national sample of 138 first- and second-year gastroenterology fellows (82% response rate). Most believed that present humanism and professionalism education met their needs, but this education was largely informal (eg, role modeling). Areas for formal education desired by >70% included competing demands of clinical practice versus research, difficult doctor–patient relationships, depression/burnout, angry parents, medical errors, work–life balance, and the patient illness experience. These results may guide curricula to formalize humanism and professionalism education in pediatric gastroenterology fellowships. PMID:23863327

  15. Graduate medical education in humanism and professionalism: a needs assessment survey of pediatric gastroenterology fellows.

    PubMed

    Garvey, Katharine C; Kesselheim, Jennifer C; Herrick, Daniel B; Woolf, Alan D; Leichtner, Alan M

    2014-01-01

    The deterioration of humanism and professionalism during graduate medical training is an acknowledged concern, and programs are required to provide professionalism education for pediatric fellows. We conducted a needs assessment survey in a national sample of 138 first- and second-year gastroenterology fellows (82% response rate). Most believed that present humanism and professionalism education met their needs, but this education was largely informal (eg, role modeling). Areas for formal education desired by >70% included competing demands of clinical practice versus research, difficult doctor-patient relationships, depression/burnout, angry parents, medical errors, work-life balance, and the patient illness experience. These results may guide curricula to formalize humanism and professionalism education in pediatric gastroenterology fellowships.

  16. Comparison of registered and published primary outcomes in randomized controlled trials of gastroenterology and hepatology.

    PubMed

    Li, Xiao-Qian; Yang, Ge-Liang; Tao, Kun-Ming; Zhang, Hui-Qing; Zhou, Qing-Hui; Ling, Chang-Quan

    2013-12-01

    OBJECTIVES. The need for trial registration as well as the benefits it has brought for the transparency of medical research has been recognized for years. Trial registration has turned from an exception to a mandatory guideline in recent years. The present study aimed to examine the characteristics of registered randomized controlled trials (RCTs) in a sample of recently published gastroenterology RCTs, and to assess the consistency of registered and published primary outcome (PO) in RCTs. METHODS. Articles published in the top five "general and internal journals" and top five "gastroenterology and hepatology journals" categories between 2009 and 2012 were searched in PubMed. Basic characteristics and the registration information were identified and extracted from the included RCTs. PO consistency analysis was conducted to compare between the registered and published format. RESULTS. A total of 305 RCTs were included; among them 252 could be identified with a registration number. Nearly half of these RCTs were funded solely by industry (141/305, 46.3%). ClinicalTrials.gov was the most popular registry for these RCTs (214/252, 84.9%). A total of 155 RCTs were included in the PO consistency analysis. Among them, 22 (14.2%) RCTs had discrepancies between POs registered in the trial registry compared to the published article. CONCLUSIONS. Based on the results of the present study, selective outcome reporting of gastroenterology RCTs published in leading medical journals has been much improved over the past years. However, there might be a sampling bias to say that consistency of registered and published POs of gastroenterology RCTs has been better than before.

  17. Helminths: an unrecognised disease burden prevalent among migrants in the gastroenterology clinic.

    PubMed

    Smith, P J; Theis, B; McCartney, S; Brown, M

    2011-04-01

    To estimate the prevalence of, and implement a diagnostic strategy for, imported helminth infection in the gastroenterology clinic. A retrospective study of eosinophil count and probable tropical exposure (phase I) followed by a prospective study of parasitological investigation (phase II). Gastroenterology service of an inner London hospital. Adult patients newly attending general gastroenterology and inflammatory bowel disease clinics. In phase I, evidence of undiagnosed helminth infection was sought by analysing patient records for associations between eosinophil count and ethnicity. In phase II, a UK guideline for investigation of eosinophilia in migrants was implemented and diagnostic yield determined. In phase I, prevalence of eosinophilia was determined; in phase II, helminth prevalence and degree of eosinophilia before and after treatment were reported. Information on symptomatic response to treatment was recorded. Ethnicity was used as a proxy measure for tropical exposure. 426 new patients attended in a 12 month period. Eosinophilia was present in 27 (6.3%). 10/27 (37.0%) patients with eosinophilia were of African or Asian ethnicity whereas only 20% (85/426) of patients overall were from these ethnic groups (χ(2)=5.27, p=0.02). Following implementation of the protocol, 25/36 migrants with eosinophilia attended for parasitological investigations. Helminth infection was diagnosed in 10/25 (40%). Strongyloidiasis (six patients) and schistosomiasis (three patients) were the most common diagnoses. Median eosinophil count was 1.06×10(9)/l in those with helminths and 0.58×10(9)/l in those without (p=0.004). Eosinophil counts normalised in, and symptomatic improvement was reported by, most patients after treatment. Eosinophilia is associated with African or Asian ethnicity in an inner city gastroenterology service. This association is probably explained by imported helminths, which are prevalent in this setting, may be a cause of gastrointestinal symptoms and

  18. Republished research: Helminths: an unrecognised disease burden prevalent among migrants in the gastroenterology clinic.

    PubMed

    Smith, P J; Theis, B; McCartney, S; Brown, M

    2012-01-01

    To estimate the prevalence of, and implement a diagnostic strategy for, imported helminth infection in the gastroenterology clinic. A retrospective study of eosinophil count and probable tropical exposure (phase I) followed by a prospective study of parasitological investigation (phase II). Gastroenterology service of an inner London hospital. Adult patients newly attending general gastroenterology and inflammatory bowel disease clinics. In phase I, evidence of undiagnosed helminth infection was sought by analysing patient records for associations between eosinophil count and ethnicity. In phase II, a UK guideline for investigation of eosinophilia in migrants was implemented and diagnostic yield determined. In phase I, prevalence of eosinophilia was determined; in phase II, helminth prevalence and degree of eosinophilia before and after treatment were reported. Information on symptomatic response to treatment was recorded. Ethnicity was used as a proxy measure for tropical exposure. 426 new patients attended in a 12 month period. Eosinophilia was present in 27 (6.3%). 10/27 (37.0%) patients with eosinophilia were of African or Asian ethnicity whereas only 20% (85/426) of patients overall were from these ethnic groups (χ(2)=5.27, p=0.02). Following implementation of the protocol, 25/36 migrants with eosinophilia attended for parasitological investigations. Helminth infection was diagnosed in 10/25 (40%). Strongyloidiasis (six patients) and schistosomiasis (three patients) were the most common diagnoses. Median eosinophil count was 1.06×10(9)/l in those with helminths and 0.58×10(9)/l in those without (p=0.004). Eosinophil counts normalised in, and symptomatic improvement was reported by, most patients after treatment. Eosinophilia is associated with African or Asian ethnicity in an inner city gastroenterology service. This association is probably explained by imported helminths, which are prevalent in this setting, may be a cause of gastrointestinal symptoms and

  19. The professional lives of women in gastroenterology: a Canadian comparison study with men.

    PubMed

    Heathcote, J; Cauch-Dudek, K; Rhyne, D

    1997-08-01

    Women are underrepresented in gastroenterology. A questionnaire examined the training and career experiences of female members of the Canadian Association for Gastroenterology (CAG) and their male counterparts. A pretested questionnaire was mailed to the 50 female CAG and 100 age-matched male members. Descriptive analyses were performed with the SAS statistical program. Questionnaires were returned by 38 of the women (76%) and 70 of the men (70%). All held full-time positions. Whereas 21.6% of the women respondents were pediatricians, all but 2.9% of the men had adult practices. The women were more likely to never marry (21.1% vs. 8.6% of men), and their personal income was significantly less than that of men. The men reported more problems juggling their work and private life, whereas problems with childcare and free time were reported more often by the women with children. The women perceived they had greater problems than men in pursuing an academic career, but grant support, academic rank, and administrative responsibilities were actually similar for both. Gender equality of opportunity was found in Canadian gastroenterology through a willingness on the part of women to compromise. Fewer women married and had families, and they earned less money than the men.

  20. Undernutrition, risk of malnutrition and obesity in gastroenterological patients: A multicenter study

    PubMed Central

    Rizzi, Massimiliano; Mazzuoli, Silvia; Regano, Nunzia; Inguaggiato, Rosa; Bianco, Margherita; Leandro, Gioacchino; Bugianesi, Elisabetta; Noè, Donatella; Orzes, Nicoletta; Pallini, Paolo; Petroni, Maria Letizia; Testino, Gianni; Guglielmi, Francesco William

    2016-01-01

    AIM: To investigate the prevalence of undernutrition, risk of malnutrition and obesity in the Italian gastroenterological population. METHODS: The Italian Hospital Gastroenterology Association conducted an observational, cross-sectional multicenter study. Weight, weight loss, and body mass index were evaluated. Undernutrition was defined as unintentional weight loss > 10% in the last three-six months. Values of Malnutrition Universal Screening Tool (MUST) > 2, NRS-2002 > 3, and Mini Nutritional Assessment (MNA) from 17 to 25 identified risk of malnutrition in outpatients, inpatients and elderly patients, respectively. A body mass index ≥ 30 indicated obesity. Gastrointestinal pathologies were categorized into acute, chronic and neoplastic diseases. RESULTS: A total of 513 patients participated in the study. The prevalence of undernutrition was 4.6% in outpatients and 19.6% in inpatients. Moreover, undernutrition was present in 4.3% of the gastrointestinal patients with chronic disease, 11.0% of those with acute disease, and 17.6% of those with cancer. The risk of malnutrition increased progressively and significantly in chronic, acute and neoplastic gastrointestinal diseases in inpatients and the elderly population. Logistical regression analysis confirmed that cancer was a risk factor for undernutrition (OR = 2.7; 95%CI: 1.2-6.44, P = 0.02). Obesity and overweight were more frequent in outpatients. CONCLUSION: More than 63% of outpatients and 80% of inpatients in gastroenterological centers suffered from significant changes in body composition and required specific nutritional competence and treatment. PMID:27559436

  1. European Society for Pediatric Gastroenterology Hepatology and Nutrition's Educational Offer and the Training Syllabus.

    PubMed

    Maglione, Marco; Finizio, Daniela; Veres, Gabor; Pop, Tudor Lucian; Continisio, Grazia Isabella; Papadopoulou, Alexandra; Guarino, Alfredo

    2017-06-21

    The basic knowledge necessary for a European pediatric gastroenterologist/hepatologist/nutritionist (PGHN) is set-out in the Training Syllabus (TS) of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN).We retrospectively compared the topics covered in ESPGHAN's training events between 2013 and 2016 with the basic knowledge TS items.Thirty-six initiatives including e-learning were identified. Twelve (33%) courses focused on gastroenterology, 9 (25%) on hepatology, and 10 (28%) on nutrition. Five (14%) courses covered more than one field and were classified "General". The initiatives covered 12/57 (21%) TS items; 31/57 items (54%) were partially covered and 14/57 (25%) not covered. Five of 9 e-learning courses covered gastroenterology topics, whereas none covered hepatology topics.ESPGHAN's three-year educational offer partially met the training needs listed in the TS. A coordinated educational program covering all TS items would harmonize training within Europe and would provide trainees with a professional portfolio for employment purposes.

  2. Methodological reporting of randomized clinical trials in major gastroenterology and hepatology journals in 2006.

    PubMed

    Bai, Yu; Gao, Jun; Zou, Duo-Wu; Li, Zhao-Shen

    2009-06-01

    To determine the current quality of reporting of randomized clinical trials (RCTs) in the field of gastroenterology and hepatology, we evaluated the methodological reporting of RCTs in six major gastroenterology and hepatology journals. The methodological quality, including generation of the allocation sequence, allocation concealment, double-blinding, and sample size calculation; number of patients; disease area; and funding source was also retrieved from each trial, and the relevant trials were identified by searching MEDLINE in 2006 using a highly sensitive search strategy. The status of reporting the methodological quality of RCTs was descriptively reported. One hundred five trials were included in the final analysis; of these, 81% (85/105) reported adequate generation of the allocation sequence, 61% (64/105) reported adequate allocation concealment, 51% (54/105) were double-blind, and 75% (79/105) reported adequate sample size calculation. The reported methodological quality greatly improved when compared with historical cohorts. This study shows that there was substantial improvement in the reported methodological quality in the major gastroenterology and hepatology journals, but this quality can be further improved.

  3. Periodic gastroenterology and hepatology meetings with primary care. Reasons for consultation.

    PubMed

    Mata-Román, Laura; del Olmo-Martínez, Lourdes; Briso-Montiano, Raquel; García-Pascual, Agustina; Catón-Valdés, Manuela; Jiménez-Rodríguez-Vila, Manuel; Castellanos-Alonso, Maria Jose; Laso, Lucinio; Gómez-Gómez, Pilar; Otero, Antonio; Pinilla-Gimeno, Jose Ignacio; del-Río-Hortega, Juan; Pradera-Leonardo, Juan; Vallelado, Rosario; Villuela-González, Fernando; Ibañes-Jalón, Elisa; Sañudo, Soledad; Mayo, Agustin; Caro-Patón, Agustin; Almaraz-Gómez, Ana

    2013-10-01

    care overload, aging of population, and increased chronic diseases lead to increased referrals from primary care, which may sometimes overload the health system. Thus, different interventions have been carried out attempting to improve these aspects. to assess the most frequent causes of consultation of general physicians, both in joint consultations and clinical sessions held jointly with specialist consultant in primary care, in the urban and rural setting, and the influence on referrals to first consultations of gastroenterology. a mainly training type of intervention was carried out, consisting of regular meetings in both urban and rural primary care center, to perform joint consultations and clinical sessions on patients and topics related to the specialty of gastroenterology. The intervention period (divided in two subperiods) was compared with a control period. most reasons for consultation were those corresponding to lower gastrointestinal tract, followed by liver disease and upper gastrointestinal tract. Significant differences were only found in distribution of diagnoses between the two centers in joint consultations. There was a relative (percent) decrease in referrals at the global level in both subperiods, only significant in the first (51.45 %), as well as in rural setting (45.24 %). common consultations motifs were similar in urban and rural settings, with some relevance of lower gastrointestinal tract disease. Most of them can be solved at primary care, with the help of consultant specialist. There is impact on referrals to the outpatient first consultations of gastroenterology, mainly in rural setting.

  4. Unemployment and underemployment in 1996 graduates of New York City gastroenterology training programs.

    PubMed

    David, J; Mogilner, A; Ozick, L A

    1998-08-01

    Based on anecdotal reports of young gastroenterologists facing extreme difficulty in finding a job, we sought to gain information about the success of newly trained gastroenterologists in finding employment in their subspecialty, and to find any possible predictors of unemployment. We surveyed all fellows finishing basic or advanced gastroenterology fellowship training in New York City in June 1996. Data were collected on unemployment, underemployment (practicing less than half-time gastroenterology), and also type of job, employment terms, training program, medical school, gender, and satisfaction with job plans. Of the 59 study subjects who sought gastroenterology employment in the United States, data were collected on all of them (100%). Fifteen subjects (25%) were unemployed. An additional 10 subjects (17%) were underemployed. Of the 24 subjects expecting to be associates in a group practice, eight (33%) had either no signed contract, were underemployed, or both. Programs that did not participate in the National Residency Matching Program were more likely to have both unemployed and underemployed graduates. Unemployment among newly trained gastroenterologists in New York City is very high. Also, there is substantial underemployment, and this phenomenon needs to be taken into account when studying the workforce.

  5. Scientific publications in gastroenterology and hepatology in Taiwan: An analysis of Web of Science from 1993 to 2013.

    PubMed

    Chang, Hsiao-Ting; Lin, Ming-Hwai; Hwang, I-Hsuan; Chen, Tzeng-Ji; Lin, Han-Chieh; Hou, Ming-Chih; Hwang, Shinn-Jang

    2017-02-01

    Scientific publications are important for evaluating the achievements of a medical specialty or discipline. Gastroenterology and Hepatology is a medical specialty in great demand in Taiwan, therefore, this study aimed to analyze the Gastroenterology and Hepatology publications from 1993 to 2013 in Taiwan, using the Web of Science (WoS) database. Scientific publications from departments/institutes of gastroenterology and hepatology were retrieved and analyzed from the WoS database, which included articles published in the Science Citation Index Expanded and Social Science Citation Index journals from 1993 to 2013. Among 229,030 articles published from departments/institutes of gastroenterology and hepatology worldwide during 1993-2013, 5061 (2.21%) were published in Taiwan, ranking the country 13(th) in the world. In total, 4759 articles from Taiwan were selected for further analysis, excluding meeting abstracts and corrections. During these two decades, the number of gastroenterology and hepatology publications increased rapidly. There were 440 articles published during 1993-1997, 646 articles during 1998-2002, 1211 articles during 2003-2007, and up to 2462 articles during 2008-2013. However, the mean number of articles cited decreased from 25.35 to 27.25 to 20.64 to 7.28, and the mean impact factor of publishing journals decreased from 5.0 to 4.20 to 4.13 to 4.03 during 1993-1997, 1998-2002, 2003-2007, and 2008-2013, respectively. Most of those publications belong to the subject category gastroenterology and hepatology (2346 articles, 49.30%), followed by surgery (677 articles, 14.23%), medicine, general and internal (358 articles, 7.52%), oncology (316 articles, 6.64%), and pharmacology pharmacy (286 articles, 6.01%). The Journal of Gastroenterology and Hepatology published the most papers (326 articles, 6.9%), followed by World Journal of Gastroenterology (201 articles, 4.2%), Hepato-Gastroenterology (165 articles, 3.5%), Gastrointestinal Endoscopy (159 articles

  6. [Zdeněk Mařatka and his share in the founding of the Czech Gastroenterological Society and its journal. Gastroenterological Society in Czech and Slovac republics].

    PubMed

    Kment, Milan

    2014-01-01

    Zdeněk Mařatka (1914-2010) was a leading person in a Czech and Slovak gastroenterology in spite of the infavourable approach of the official communist policy to him.. He was one of the founders of gastroenterology in Czechoslovakia. He had been habilitated in 1948 for thesis Ulcerative colitis. Mařatka stood at the first steps of foundation of Czech Gastroenterology Society very soon after the WW2 and followed with the preparation as a secretary ge-neral of the 8th ASNEMGE Congress in Prague 1968 and as a president the 1st Congress of Endoscopy in the very optimistic atmosphere of ,,Prague Spring". He was nominated or elected by several international gastroenterology organisations, during 1976-1980 had been President of ESGE. He started with editoring of Czech gastroenterology Association journal as a member of editorial board and had been its main editor between 1969-1999. His well appreciated novelty in the magazine was a short remarks in one or two sentences from the world scientific literature which appeared in every copy. As an editor emeritus he supported the quality of the journal by many advices and contributions including articles.

  7. Attitudes and Usage of the Food and Drug Administration Adverse Event Reporting System Among Gastroenterology Nurse Practitioners and Physician Assistants.

    PubMed

    Salk, Allison; Ehrenpreis, Eli D

    2016-01-01

    The Food and Drug Administration Adverse Event Reporting System (FAERS) is used for postmarketing pharmacovigilance. Our study sought to assess attitudes and usage of the FAERS among gastroenterology nurse practitioners (NPs) and physician assistants (PAs). A survey was administered at the August 2012 Principles of Gastroenterology for the Nurse Practitioner and Physician Assistant course, held in Chicago, IL. Of the 128 respondents, 123 (96%) reported a specialty in gastroenterology or hepatology and were included in analysis. Eighty-nine participants were NPs and 32 PAs, whereas 2 did not report their profession. Although 119 (98%) agreed or strongly agreed with the statement that accurately reporting adverse drug reactions is an important process to optimize patient safety, the majority of participants (54% NPs and 81% PAs) were unfamiliar with the FAERS. In addition, only 20% of NPs and 9% of PAs reported learning about the FAERS in NP or PA schooling. Our study shows enthusiasm among gastroenterology NPs and PAs for the reporting of adverse drug reactions, coupled with a lack of familiarity with the FAERS. This presents an opportunity for enhanced education about reporting of adverse drug reactions for gastroenterology NPs and PAs.

  8. Analysis of Research Activity in Gastroenterology: Pancreatitis Is in Real Danger

    PubMed Central

    Szentesi, Andrea; Tóth, Emese; Bálint, Emese; Fanczal, Júlia; Madácsy, Tamara; Laczkó, Dorottya; Ignáth, Imre; Balázs, Anita; Pallagi, Petra; Maléth, József; Rakonczay, Zoltán; Kui, Balázs; Illés, Dóra; Márta, Katalin; Blaskó, Ágnes; Demcsák, Alexandra; Párniczky, Andrea; Pár, Gabriella; Gódi, Szilárd; Mosztbacher, Dóra; Szücs, Ákos; Halász, Adrienn; Izbéki, Ferenc; Farkas, Nelli; Hegyi, Péter

    2016-01-01

    Objective Biomedical investment trends in 2015 show a huge decrease of investment in gastroenterology. Since academic research usually provides the basis for industrial research and development (R&D), our aim was to understand research trends in the field of gastroenterology over the last 50 years and identify the most endangered areas. Methods We searched for PubMed hits for gastrointestinal (GI) diseases for the 1965–2015 period. Overall, 1,554,325 articles were analyzed. Since pancreatology was identified as the most endangered field of research within gastroenterology, we carried out a detailed evaluation of research activity in pancreatology. Results In 1965, among the major benign GI disorders, 51.9% of the research was performed on hepatitis, 25.7% on pancreatitis, 21.7% on upper GI diseases and only 0.7% on the lower GI disorders. Half a century later, in 2015, research on hepatitis and upper GI diseases had not changed significantly; however, studies on pancreatitis had dropped to 10.7%, while work on the lower GI disorders had risen to 23.4%. With regard to the malignant disorders (including liver, gastric, colon, pancreatic and oesophageal cancer), no such large-scale changes were observed in the last 50 years. Detailed analyses revealed that besides the drop in research activity in pancreatitis, there are serious problems with the quality of the studies as well. Only 6.8% of clinical trials on pancreatitis were registered and only 5.5% of these registered trials were multicentre and multinational (more than five centres and nations), i.e., the kind that provides the highest level of impact and evidence level. Conclusions There has been a clear drop in research activity in pancreatitis. New international networks and far more academic R&D activities should be established in order to find the first therapy specifically for acute pancreatitis. PMID:27776171

  9. Gastroenterology training in a resource-limited setting: Zambia, Southern Africa

    PubMed Central

    Asombang, Akwi W; Turner-Moss, Eleanor; Seetharam, Anil; Kelly, Paul

    2013-01-01

    AIM: To evaluate need for and efficacy of a structured gastroenterology didactic session in expanding awareness and understanding of digestive disorders. METHODS: A four-day symposium was developed with didactic sessions (days 1, 2) and practical endoscopy (days 3, 4). Didactic sessions included case presentations highlighting pathophysiology and management. One nurse and four practicing gastroenterologists from the United Kingdom led lectures and supervised workshops with audience participation. Practical endoscopy focused on diagnostic and therapeutic procedures and their application to diagnosis and treatment of ailments of the gastrointestinal tract. Pre- and post-workshop questionnaires were distributed to participants during didactic sessions. A pre-workshop questionnaire gauged expectations and identified objectives to be met at the symposium. Post-workshop questionnaires were administered to assess efficacy of each session. Participants graded sessions from 1 (poor) to 5 (excellent) on quality of case presentations, knowledge, clarity and mode of presentation. We assessed if time allotted to each topic was sufficient, value of sessions, impact on practice and interest in future symposiums. RESULTS: There were 46 attendees on day 1: 41% undergraduates, 41% residents, 11% consultants and 4% unspecified. Day 2 (a Saturday) had 24 participants: 17% undergraduates, 71% residents, 9% consultants, 4% unspecified. Primary pre-workshop symposium expectation was to gain knowledge in: general gastroenterology (55.5%), practical endoscopy (13.8%), pediatric gastroenterology (5%), epidemiology of gastrointestinal disorders specific to Zambia (6%), and interaction with international speakers (6%). The post-symposium questionnaire was answered by 19 participants, of whom 95% felt specific aims were met; all would attend future conferences and recommend to others. CONCLUSION: The beneficial effect of a structured symposium in developing countries warrants further attention

  10. Women’s Health Training in Gastroenterology Fellowship: A National Survey of Fellows and Program Directors

    PubMed Central

    Roberson, Erica; Richie, Kelly; Lindstrom, Mary J.; Esposti, Silvia Degli; Wald, Arnold

    2013-01-01

    Background and Aims The Gastroenterology Core Curriculum requires training in women’s digestive disorders; however, requirements do not necessarily produce knowledge and competence. Our study goals were: (1) to compare perceptions of education, fellow-reported levels of competence, and attitudes towards training in women’s gastrointestinal (GI) health issues during fellowship between gastroenterology fellows and program directors, and (2) to determine the barriers for meeting training requirements. Methods A national survey assessing four domains of training was conducted. All GI program directors in the United States (n = 153) and a random sample of gastroenterology fellows (n = 769) were mailed surveys. Mixed effects linear modeling was used to estimate all mean scores and to assess differences between the groups. Cronbach’s alpha was used to assess the consistency of the measures which make up the means. Results Responses were received from 61% of program directors and 31% of fellows. Mean scores in perceived didactic education, clinical experiences, and competence in women’s GI health were low and significantly differed between the groups (P < 0.0001). Fellows’ attitudes towards women’s GI health issues were more positive compared to program directors’ (P = 0.004). Barriers to training were: continuity clinic at a Veteran’s Administration hospital, low number of pregnant patients treated, low number of referrals from obstetrics and gynecology, and lack of faculty interest in women’s health. Conclusions (1) Fellows more so than program directors perceive training in women’s GI health issues to be low. (2) Program directors more so than fellows rate fellows to be competent in women’s GI health. (3) Multiple barriers to women’s health training exist. PMID:21267780

  11. The effect of Nazism on medical progress in gastroenterology: the inefficiency of evil.

    PubMed

    Cappell, Mitchell S

    2006-06-01

    While Nazism is almost universally recognized as a great evil, control of science and medicine by the totalitarian Nazi state might be viewed as increasing efficiency. Scientific methods are applied to semiquantitatively analyze the effects of Nazism on medical progress in gastroenterology to document its pernicious effects, and to honor outstanding gastroenterologists persecuted or murdered by the Nazis. This is a retrospective, quasi-case-controlled study. To disprove the null hypothesis that Nazism was efficient, retarded progress in gastroenterology is demonstrated by (1) enumerating the loss to Nazi Germany from 1933 to 1944 due to violent death, incarceration, or forced exile of key researchers in gastroenterology, defined by authorship of at least one book or 10 articles in peer-reviewed journals or other outstanding scholarship; (2) demonstrating a statistically significantly greater loss in Nazi Germany than in non-Nazi (Weimar German Republic from 1921 to 1932) or anti-Nazi (democratic America from 1933 to 1944) control groups; and (3) demonstrating that each loss was directly due to Nazism (murder, incarceration, or exile due to documented threat of violence/death or revocation of medical license). Sources of error in analyzing events from 70 years ago are described. Nazi Germany and Nazi-occupied Europe gained 0 and lost 53 key gastroenterology researchers, including 32 lost due to forced exile, 11 murdered by the Nazis, 5 lost due to suicide under threat of violence, 3 in hiding from the Gestapo, and 2 for other reasons. Fifty-two of the gastroenterologists were persecuted solely because they were Jewish or of Jewish descent and one because he was a Christian anti-Nazi Polish patriot. Particularly severe losses occurred in endoscopy. The loss in Nazi Germany from 1933 to 1944 was significantly greater than that in non-Nazi Germany and Austria from 1921 to 1932 (53 versus 4; odds ratio = 25.27; 95% CI: 9.01-70.48; P < 0.0001) and was significantly

  12. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology

    PubMed Central

    Ludvigsson, Jonas F; Bai, Julio C; Biagi, Federico; Card, Timothy R; Ciacci, Carolina; Ciclitira, Paul J; Green, Peter H R; Hadjivassiliou, Marios; Holdoway, Anne; van Heel, David A; Kaukinen, Katri; Leffler, Daniel A; Leonard, Jonathan N; Lundin, Knut E A; McGough, Norma; Davidson, Mike; Murray, Joseph A; Swift, Gillian L; Walker, Marjorie M; Zingone, Fabiana; Sanders, David S

    2014-01-01

    A multidisciplinary panel of 18 physicians and 3 non-physicians from eight countries (Sweden, UK, Argentina, Australia, Italy, Finland, Norway and the USA) reviewed the literature on diagnosis and management of adult coeliac disease (CD). This paper presents the recommendations of the British Society of Gastroenterology. Areas of controversies were explored through phone meetings and web surveys. Nine working groups examined the following areas of CD diagnosis and management: classification of CD; genetics and immunology; diagnostics; serology and endoscopy; follow-up; gluten-free diet; refractory CD and malignancies; quality of life; novel treatments; patient support; and screening for CD. PMID:24917550

  13. International experience on the use of artificial neural networks in gastroenterology.

    PubMed

    Grossi, E; Mancini, A; Buscema, M

    2007-03-01

    In this paper, we reconsider the scientific background for the use of artificial intelligence tools in medicine. A review of some recent significant papers shows that artificial neural networks, the more advanced and effective artificial intelligence technique, can improve the classification accuracy and survival prediction of a number of gastrointestinal diseases. We discuss the 'added value' the use of artificial neural networks-based tools can bring in the field of gastroenterology, both at research and clinical application level, when compared with traditional statistical or clinical-pathological methods.

  14. Nuclear gastroenterology

    SciTech Connect

    Robinson, P.

    1986-01-01

    This book contains the following chapters: Scintigraphy of the oesopohagus; Gastric emptying; Bile dynamics; Scintigraphy in diffuse liver disease; Scintigraphic diagnosis of liver tumors; Acute cholecystitis; Radiolabelled white cells in inflammatory disease; Scintigraphy in gastrointestinal bleeding; Radiolabelled antibodies for imaging of gastrointestinal tumors; Assessment of the small intestine; and Gastrointestinal scintigraphy in pediatrics.

  15. United European Gastroenterology Week scientific abstracts and their progression to full publication.

    PubMed

    Raju, Suneil A; Sanders, David S; Akram, Rahim; Glover, Rebecca; Al-Rifaie, Ammar; Peever, Elise; Purves, Josh; Scanu, Emily; Kurien, Matthew

    2017-10-01

    Abstracts presentations at scientific meetings enable rapid dissemination of novel research. The percentage of abstracts that proceed to full publication from differing medical specialties is highly variable. This study aims to evaluate the outcomes of abstracts presented at the United European Gastroenterology Week (UEGW). All abstracts presented at UEGW between 2009 and 2011 were assessed. Cross-referencing of the first author, senior author and at least one keyword of the abstract was performed using PubMed and EMBASE databases. Abstracts and possible resultant full publications were then examined in tandem to ensure that they represented the same study. Data were also collected on lag time to publication, journal impact factors, country of the author and factors influencing subsequent publication. A total of 6785 abstracts (1438 oral and 5347 poster presentations) were presented during the period assessed. Of these, 2099 (30.9%) proceeded to full publication in indexed journals. Oral abstract presentations were most likely to proceed to full publication compared with poster presentations (odds ratio: 1.38, 95% confidence interval: 1.22-1.56) and were more likely to achieve publication in higher impact journals (median impact factor 4.78 vs. 2.89, P<0.0005). The median lag time to full publication was 15 (IQR: 7-15) months. The Netherlands had the highest United European Gastroenterology abstract conversion rate to full publication (46.8%). This is the first study to assess the publication rates of UEGW. Findings are favourable with similar studies from other societies.

  16. Evaluation of funding gastroenterology research in Canada illustrates the beneficial role of partnerships.

    PubMed

    Sherman, Philip M; Banks Hart, Kimberly; Rose, Keeley L; Bosompra, Kwadwo; Manuel, Christopher; Belanger, Paul; Daniels, Sandra; Sinclair, Paul; Vanner, Stephen; Buret, Andre

    2013-12-01

    Funders of health research in Canada seek to determine how their funding programs impact research capacity and knowledge creation. To evaluate the impact of a focused grants and award program that was cofunded by the Canadian Institutes of Health Research Institute of Nutrition, Metabolism and Diabetes, and the Canadian Association of Gastroenterology; and to measure the impact of the Program on the career paths of funded researchers and assess the outcomes of research supported through the Program. A survey of the recipients of grants and awards from 2000 to 2008 was conducted in 2012. The CIHR Funding Decisions database was searched to determine subsequent funding; a bibliometric citation analysis of publications arising from the Program was performed. Of 160 grant and award recipients, 147 (92%) completed the survey. With >$17.4 million in research funding, support was provided for 131 fellowship awards, seven career transition awards, and 22 operating grants. More than three-quarters of grant and award recipients continue to work or train in a research-related position. Combined research outputs included 545 research articles, 130 review articles, 33 book chapters and 11 patents. Comparative analyses indicate that publications supported by the funding program had a greater impact than other Canadian and international comparators. Continuity in support of a long-term health research funding partnership strengthened the career development of gastroenterology researchers in Canada, and enhanced the creation and dissemination of new knowledge in the discipline.

  17. [International outcomes from attempts to implement a clinical decision support system in gastroenterology].

    PubMed

    Tenório, Josceli Maria; Hummel, Anderson Diniz; Sdepanian, Vera Lucia; Pisa, Ivan Torres; de Fátima Marin, Heimar

    2011-01-01

    This study aimed at describing the recent experience acquired with the implementation and use of clinical decision support system in gastroenterology in order to determine the level of development, tests used and advantages that such a system can offer to the medical practice. A search in the PubMed, LILACS and ISI Web of Knowledge databases for studies in decision-making support systems in gastroenterology including original papers produced from 2005 to 2010 was performed. A total of 104 scientific papers were retrieved initially. These were analyzed using inclusion and exclusion criteria, thus yielding nine studies for further analysis. The clinical decision support system analyzed in the present study showed a great variety of clinical problems regarding the investigation of a disease and the determination of a diagnosis. Eighty-nine per cent of the studies showed experimental models for clinical decision support system development. Seventy-eight per cent of the studies described the outcomes obtained with artificial intelligence technique. Two studies compared the clinical decision support system performance with that of a doctor, and only one research work described a controlled study evidencing improvements in the medical practice. The studies analyzed showed evidence of potential benefits that clinical decision support system can bring to the clinical practice. However, further controlled studies performed in medical day-to-day conditions and environment should be performed in order to provide more clear evidence of the usefulness of clinical decision support system in the medical practice.

  18. Single port laparoscopy in gastroenterology and hepatology: a fine step forward.

    PubMed

    Mittermair, Christof; Schirnhofer, Jan; Brunner, Eberhard; Pimpl, Katharina; Obrist, Christian; Weiss, Michael; Weiss, Helmut G

    2014-11-14

    Single incision laparoscopy (SIL) has become an emerging technology aiming at a further reduction of abdominal wall trauma in minimally invasive surgery. Available data is encouraging for the safe application of standardized SIL in a wide range of procedures in gastroenterology and hepatology. Compared to technically simple SIL procedures, the merit of SIL in advanced surgeries, such as liver or colorectal interventions, compared to conventional laparsocopy is self-evident without any doubt. SIL has already passed the learning curve and is routinely utilized in expert centers. This minimized approach has allowed to enter a new era of surgical management that can not be acceded without a fruitful combination of prudent training, consistent day-to-day work and enthusiastic motivation for technical innovations. Both, basic and novel technical specifics as well as particular procedures are described herein. The focus is on the most important surgical interventions in gastroenterology and aims at reviewing the current literature and shares our experience in a high volume center.

  19. Nutrition Education for Pediatric Gastroenterology, Hepatology and Nutrition Fellows: A Survey of NASPGHAN Fellowship Training Programs

    PubMed Central

    Martinez, J. Andres; Koyama, Tatsuki; Acra, Sari; Mascarenhas, Maria R.; Shulman, Robert J.

    2012-01-01

    Objectives The aim of the study was to assess the methodology and content of nutrition education during gastroenterology fellowship training and the variability among the different programs. Methods A survey questionnaire was completed by 43 fellowship training directors of 62 active programs affiliated to NASPGHAN, including sites in the United States, Canada and Mexico. The data were examined for patterns in teaching methodology and coverage of specific nutrition topics based on Level 1 training in nutrition, which is the minimum requirement according to published NASPGHAN fellowship training guidelines. Results The majority of the teaching was conducted by MD degree faculty (61%), and most of the education was provided through clinical care experiences. Only 31% of Level 1 nutrition topics were consistently covered by more than 80% of programs, and coverage did not correlate with the size of the programs. Competency in nutrition training was primarily assessed through questions to individuals or groups of fellows (77 and 65%, respectively). Program directors cited a lack of faculty interested in nutrition and a high workload as common obstacles for teaching. Conclusions The methodology of nutrition education during gastroenterology fellowship training is for the most part unstructured and inconsistent among the different programs. The minimum Level 1 requirements are not consistently covered. The development of core curriculums and learning modules may be beneficial in improving nutrition education. PMID:22343911

  20. Single port laparoscopy in gastroenterology and hepatology: A fine step forward

    PubMed Central

    Mittermair, Christof; Schirnhofer, Jan; Brunner, Eberhard; Pimpl, Katharina; Obrist, Christian; Weiss, Michael; Weiss, Helmut G

    2014-01-01

    Single incision laparoscopy (SIL) has become an emerging technology aiming at a further reduction of abdominal wall trauma in minimally invasive surgery. Available data is encouraging for the safe application of standardized SIL in a wide range of procedures in gastroenterology and hepatology. Compared to technically simple SIL procedures, the merit of SIL in advanced surgeries, such as liver or colorectal interventions, compared to conventional laparsocopy is self-evident without any doubt. SIL has already passed the learning curve and is routinely utilized in expert centers. This minimized approach has allowed to enter a new era of surgical management that can not be acceded without a fruitful combination of prudent training, consistent day-to-day work and enthusiastic motivation for technical innovations. Both, basic and novel technical specifics as well as particular procedures are described herein. The focus is on the most important surgical interventions in gastroenterology and aims at reviewing the current literature and shares our experience in a high volume center. PMID:25400443

  1. Current Status of and Recommendations for Nutrition Education in Gastroenterology Fellowship Training in Canada.

    PubMed

    Hu, Jing; Raman, Maitreyi; Gramlich, Leah

    2017-04-01

    Knowledge and skill in the area of nutrition are a key competency for the gastroenterologist. However, standards for nutrition education for gastroenterology fellows in Canada do not exist, and gastroenterologists in training and in practice do not feel confident in their knowledge or skill as it relates to nutrition. This study was undertaken to identify the current status of nutrition education in gastroenterology (GI) fellowship training programs in Canada and to provide insight into the development of nutrition educational goals, processes, and evaluation. Using mixed methods, we did a survey of current and recent graduates and program directors of GI fellowship programs in Canada. We undertook a focus group with program directors and fellows to corroborate findings of the survey and to identify strategies to advance nutrition education, knowledge, and skill of trainees. In total, 89.3% of the respondents perceived that the nutrition education was important for GI training, and 82.1% of the respondents perceived nutrition care would be part of their practice. However, only 50% of respondents had a formal rotation in their program, and it was mandatory only 36% of the time. Of the respondents, 95% felt that nutrition education should be standardized within GI fellowship training. Significant gaps in nutrition education exist with GI fellowship programs in Canada. The creation of standards for nutrition education would be valued by training programs, and such a nutrition curriculum for GI fellowship training in Canada is proposed.

  2. Evaluation of funding gastroenterology research in Canada illustrates the beneficial role of partnerships

    PubMed Central

    Sherman, Philip M; Hart, Kimberly Banks; Rose, Keeley; Bosompra, Kwadwo; Manuel, Christopher; Belanger, Paul; Daniels, Sandra; Sinclair, Paul; Vanner, Stephen; Buret, André G

    2013-01-01

    BACKGROUND: Funders of health research in Canada seek to determine how their funding programs impact research capacity and knowledge creation. OBJECTIVE: To evaluate the impact of a focused grants and award program that was cofunded by the Canadian Institutes of Health Research Institute of Nutrition, Metabolism and Diabetes, and the Canadian Association of Gastroenterology; and to measure the impact of the Program on the career paths of funded researchers and assess the outcomes of research supported through the Program. METHODS: A survey of the recipients of grants and awards from 2000 to 2008 was conducted in 2012. The CIHR Funding Decisions database was searched to determine subsequent funding; a bibliometric citation analysis of publications arising from the Program was performed. RESULTS: Of 160 grant and award recipients, 147 (92%) completed the survey. With >$17.4 million in research funding, support was provided for 131 fellowship awards, seven career transition awards, and 22 operating grants. More than three-quarters of grant and award recipients continue to work or train in a research-related position. Combined research outputs included 545 research articles, 130 review articles, 33 book chapters and 11 patents. Comparative analyses indicate that publications supported by the funding program had a greater impact than other Canadian and international comparators. CONCLUSIONS: Continuity in support of a long-term health research funding partnership strengthened the career development of gastroenterology researchers in Canada, and enhanced the creation and dissemination of new knowledge in the discipline. PMID:24340317

  3. Prevalence of Barrett's esophagus: An observational study from a gastroenterology clinic.

    PubMed

    Herrera Elizondo, J L; Monreal Robles, R; García Compean, D; González Moreno, E I; Borjas Almaguer, O D; Maldonado Garza, H J; González González, J A

    2017-07-04

    Barrett's esophagus is a condition that predisposes to esophageal adenocarcinoma. Our aim was to establish the prevalence of Barrett's esophagus at our center, as well as determine its associated factors. We retrospectively assessed the endoscopic reports of 500 outpatients seen at our Gastroenterology Service from November 2014 to April 2016. We determined the prevalence of Barrett's esophagus and analyzed the demographic, clinical, and endoscopic findings associated with that pathology. The prevalence of Barrett's esophagus was 1.8%. The mean age of the patients with Barrett's esophagus was 58.7 years (range: 45-70) and there was a predominance of men (66%). In the subgroup of patients with symptoms of gastroesophageal reflux (n=125), Barrett's esophagus prevalence was 7.2%. In the multivariate analysis, the factors that were independently associated with Barrett's esophagus were gastroesophageal reflux (P=.005) and hiatal hernia (P=.006). The overall prevalence of Barrett's esophagus was 1.8% in our population, with a prevalence of 7.2% in patients that had symptoms of gastroesophageal reflux. Copyright © 2017 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  4. The practice of evidence-based medicine (EBM) in gastroenterology: discrepancies between EBM familiarity and EBM competency

    PubMed Central

    Buscaglia, Jonathan; Nagula, Satish; Yuan, Jay; Bucobo, Juan Carlos; Kumar, Atul; Forsmark, Chris E.; Draganov, Peter V.

    2011-01-01

    Introduction: Evidence-based medicine (EBM) has become increasingly important in the practice of gastroenterology and endoscopy, and the training of future gastroenterology physicians. The objectives were to assess the attitudes/opinions of gastroenterology specialists towards EBM, and evaluate possible gaps in education for certain EBM-related concepts. Methods: An internet-based survey was emailed to 4073 gastroenterology specialists. The main outcome measurements were physicians’ endorsement of EBM, impact of EBM on clinical practice, utilization of EBM-specific resources, self-assessed understanding of EBM concepts (EBM familiarity score), and actual knowledge of EBM concepts (EBM competency score). Results: A total of 337 gastroenterology specialists participated. On a sale of 1–10, there was widespread agreement that EBM improves patient care (median score = 9, interquartile range (IQR) = 7–10), and physicians should be familiar with techniques for critical appraisal of studies (median = 9, IQR = 8–10). Most (64.0%) utilized the EBM-related resource UpToDate™ regularly, as opposed to PubMed™ (47.1%) or Clinical Evidence™ (5.4%). The mean EBM familiarity score was 3.4 ± 0.6 on a scale of 1–4. Out of a maximum 49 points, the mean EBM competency score was 35 ± 4.9. There was poor concordance among EBM familiarity and competency scores (r = 0.161; p = 0.005). Academic practice (p < 0.001), research/teaching (p < 0.001), advanced degree (p = 0.012), and recent EBM training (p = 0.001) were all associated with improved EBM competency. Conclusion: The attitudes and opinions of EBM are extremely favorable among gastroenterology physicians. Although gastroenterology physicians report familiarity with most EBM-related concepts, there is poor correlation with their actual knowledge of EBM. Further educational initiatives should be undertaken to address methods in which EBM skills are reinforced among all

  5. The practice of evidence-based medicine (EBM) in gastroenterology: discrepancies between EBM familiarity and EBM competency.

    PubMed

    Buscaglia, Jonathan; Nagula, Satish; Yuan, Jay; Bucobo, Juan Carlos; Kumar, Atul; Forsmark, Chris E; Draganov, Peter V

    2011-09-01

    Evidence-based medicine (EBM) has become increasingly important in the practice of gastroenterology and endoscopy, and the training of future gastroenterology physicians. The objectives were to assess the attitudes/opinions of gastroenterology specialists towards EBM, and evaluate possible gaps in education for certain EBM-related concepts. An internet-based survey was emailed to 4073 gastroenterology specialists. The main outcome measurements were physicians' endorsement of EBM, impact of EBM on clinical practice, utilization of EBM-specific resources, self-assessed understanding of EBM concepts (EBM familiarity score), and actual knowledge of EBM concepts (EBM competency score). A total of 337 gastroenterology specialists participated. On a sale of 1-10, there was widespread agreement that EBM improves patient care (median score = 9, interquartile range (IQR) = 7-10), and physicians should be familiar with techniques for critical appraisal of studies (median = 9, IQR = 8-10). Most (64.0%) utilized the EBM-related resource UpToDate™ regularly, as opposed to PubMed™ (47.1%) or Clinical Evidence™ (5.4%). The mean EBM familiarity score was 3.4 ± 0.6 on a scale of 1-4. Out of a maximum 49 points, the mean EBM competency score was 35 ± 4.9. There was poor concordance among EBM familiarity and competency scores (r = 0.161; p = 0.005). Academic practice (p < 0.001), research/teaching (p < 0.001), advanced degree (p = 0.012), and recent EBM training (p = 0.001) were all associated with improved EBM competency. The attitudes and opinions of EBM are extremely favorable among gastroenterology physicians. Although gastroenterology physicians report familiarity with most EBM-related concepts, there is poor correlation with their actual knowledge of EBM. Further educational initiatives should be undertaken to address methods in which EBM skills are reinforced among all gastroenterology practitioners.

  6. [Simulation of the interaction of gastroenterologists, endoscopists and surgeons, as the present and the future of high-tech gastroenterology of Chuvashia].

    PubMed

    Tarasova, L V; Mullina, V P; Voronchikhin, V V; Averina, N N

    2013-01-01

    The analysis of the joint work of gastroenterologists, surgeons and endoscopists Republican gastroenterological center of the Chuvash Republic. The importance of creating a model of interaction of gastroenterologists, surgeons and endoscopists for the development of high-tech gastroenterology in the Chuvash Republic.

  7. [Ethical dilemmas in gastroenterology practice in Latin-American countries: the AIGE survey].

    PubMed

    Jmelnitzky, A C; Cohen, H; Fossman, E; Ovando, L; Costa Gil, J E

    1999-01-01

    A survey sponsored by the Interamerican Association of Gastroenterology (AIGE) related to decision making in conflictive ethical situations in the setting of gastroenterological practice was designed (AJ-JCG). Seven problem-cases with 3 to 5 pre-established and not-excluding answers each, demographic and occupational data were included, by public invitation during 1996-97 AIGE educational activities in La Plata (Argentina), Montevideo (Uruguay) and Santo Domingo (Dominican Republic). Data were inserted in a computerised data base, and chi square, Fischer and Maentel-Henzel tests were used for statistical studies. 118 out of 460 doctors registered to educational activities answered at the survey (25.6%). Mean age was 42 +/- 15 years and 57.6% were male; 48.5% were under 10 years of professional practice and 19.5% were over 20 years. Gastroenterology was the main specialty in 89.8%. Although only 15.2% of participants reported as not having Ethical Committee (EC) in their institutions, the option of consulting was not very frequently selected, except in cases of request about pregnancy interruption in the HCV infected mother (22.9%), inclusion of the young alcoholic cirrhotic man in the waiting list for liver trasplant (17.8%), and the Jehova's Witness conscious patient with bleeding esophageal varices (13.5%). Cases of direct communication to the patient of early colon cancer diagnosis (66.1%), and inclusion of the young end stage alcoholic cirrhotic patient in the waiting list for liver trasplantation (65.2%), had the higher consensus. On the other hand, lower consensus (39%) was seen in the case of variceal bleeding in the encephalopathic Witness of Jehova patient. Differential criterla were observed related to sex: 38% of women versus 14.7% of men (p < 0.01) refuse the interruption of pregnancy to the infected HCV patient because of personal convictions against abortion. In the case of suspected HIV co-infection in the IVD HBsAG + carrier, 46% of women vs. 27

  8. [The role of Orvosi Hetilap in the development of contemporary Hungarian gastroenterology. Part 4: 1989-2008].

    PubMed

    Buzás, György Miklós

    2009-04-12

    The editions of Orvosi Hetilap published between 1948 and 1989 easily exceeded the number of publications in the previous period. Most of the knowledge was transferred from English literature. Evaluate the papers dealing with diseases of the gastrointestinal tract published in Orvosi Hetilap between 1989 and 2008. The author manually reviewed the journal volumes published between 1989 and 1208. The original articles, journal and book reviews were identified and classified according to their subject and origin. The publication rates of the editorial periods 1948-1989 and 1989-2008 were statistically compared. Between 1989 and 2008 a total of 2817 publications appeared on the diseases of the gastrointestinal tract (1067 original articles, 1698 journal and 52 book reviews), constituting 10.1% of all publications. The annual rate of the original articles in the periods studied was similar (p = 0.82), while that of journal and book reviews decreased significantly (p = 0.006 and p = 0.01, respectively). The online version of Orvosi Hetilap and the English version of the journal, entitled Hungarian Medical Journal , became available from 2007. Liver (17.8%) and biliary tract diseases were studied the most (4.3%), especially viral hepatitis (7%). Laparoscopic surgery was studied in 27 articles (1.8%), while liver transplantation achieved a figure of 39 (2.6%). The genetics of gastrointestinal diseases were studied in 61 (4.0%) articles. 1,698 articles were reviewed from 131 journals, which constitutes a significant decrease as compared to the previous period. 65.4% of the reviews were published in 15 core journals. 62.4% of the journals were English, 31.5% were German and only 1.6% French, thus te previous dominance of the English literature was enhanced. The number of book reviews decreased from 211 to 52 (p = 0.01). The Hungarian experience in laparoscopic surgery was published in part in Orvosi Hetilap . The journal was the main forum for the articles on liver

  9. Bibliometric analysis of the top-cited gastroenterology and hepatology articles

    PubMed Central

    Azer, Samy A; Azer, Sarah

    2016-01-01

    Objective To identify the top-cited articles in gastroenterology and hepatology, and analyse their characteristics. Methods Two searches were conducted in the Science Citation Index Expanded database; a search of 69 journals under the category ‘Gastroenterology and Hepatology’ (list A) and a keyword search of all journals (list B). The search results were analysed and the inter-rater coefficient of agreement between evaluators was measured using Cohen κ. Results The number of citations varied from 1049 to 2959 in list A and from 1929 to 5500 in list B. In both lists, the majority of articles were research papers. No significant correlations were found between the number of citations and the number of years since publication (R2=0.00992, p=0.473 and R2=0.00202, p=0.757, respectively). However, the mean number of citations of papers published before the year 2000 was lower than those published after 2000 (36.70±19.31 vs 106.03±39.22). No correlation was found between number of authors and the number of citations (R2=0.04352, p=0.130), but strong correlations were found between the number of institutes involved or number of countries and the number of citations (R2=0.275, p<0.001 and R2=0.16181, p=0.003, respectively). Females were under-represented in authorship (45 vs 254, p=0.004). Only 21 papers (of 54) in list A were supported by grants. No correlation was found between number of grants received and the number of citations (R2=0.02573, p=0.247). The inter-rater agreement between evaluators had a Cohen κ coefficient 0.76–0.84. Conclusions Top-cited articles were not only published in highly ranked journals specialising in Gastroenterology and Hepatology but also in 14 journals not specialised in this field. The number of citations correlated with the number of institutes and the number of countries involved but not with the number of grants received or the number of authors. Females were under-represented in the authorship. PMID:26857105

  10. Bibliometric analysis of the top-cited gastroenterology and hepatology articles.

    PubMed

    Azer, Samy A; Azer, Sarah

    2016-02-08

    To identify the top-cited articles in gastroenterology and hepatology, and analyse their characteristics. Two searches were conducted in the Science Citation Index Expanded database; a search of 69 journals under the category 'Gastroenterology and Hepatology' (list A) and a keyword search of all journals (list B). The search results were analysed and the inter-rater coefficient of agreement between evaluators was measured using Cohen κ. The number of citations varied from 1049 to 2959 in list A and from 1929 to 5500 in list B. In both lists, the majority of articles were research papers. No significant correlations were found between the number of citations and the number of years since publication (R(2)=0.00992, p=0.473 and R(2)=0.00202, p=0.757, respectively). However, the mean number of citations of papers published before the year 2000 was lower than those published after 2000 (36.70 ± 19.31 vs 106.03 ± 39.22). No correlation was found between number of authors and the number of citations (R(2)=0.04352, p=0.130), but strong correlations were found between the number of institutes involved or number of countries and the number of citations (R(2)=0.275, p<0.001 and R(2)=0.16181, p=0.003, respectively). Females were under-represented in authorship (45 vs 254, p=0.004). Only 21 papers (of 54) in list A were supported by grants. No correlation was found between number of grants received and the number of citations (R(2)=0.02573, p=0.247). The inter-rater agreement between evaluators had a Cohen κ coefficient 0.76-0.84. Top-cited articles were not only published in highly ranked journals specialising in Gastroenterology and Hepatology but also in 14 journals not specialised in this field. The number of citations correlated with the number of institutes and the number of countries involved but not with the number of grants received or the number of authors. Females were under-represented in the authorship. Published by the BMJ Publishing Group Limited. For

  11. Kinematic analysis of wrist motion during simulated colonoscopy in first-year gastroenterology fellows

    PubMed Central

    Ratuapli, Shiva K; Ruff, Kevin C; Ramirez, Francisco C; Wu, Qing; Mohankumar, Deepika; Santello, Marco; Fleischer, David E

    2015-01-01

    Background and study aims: Gastroenterology trainees acquire skill and proficiency in performing colonoscopies at different rates. The cause for heterogeneous competency among the trainees is unclear. Kinematic analysis of the wrist joint while performing colonoscopy can objectively assess the variation in wrist motion. Our objective was to test the hypothesis that the time spent by the trainees in extreme ranges of wrist motion will decrease as the trainees advance through the fellowship year. Subjects and methods: Five first-year gastroenterology fellows were prospectively studied at four intervals while performing simulated colonoscopies. The setting was an endoscopy simulation laboratory at a tertiary care center. Kinematic assessment of wrist motion was done using a magnetic position/orientation tracker held in place by a custom-made arm sleeve and hand glove. The main outcome measure was time spent performing each of four ranges of wrist motion (mid, center, extreme, and out) for each wrist degree of freedom (pronation/supination, flexion/extension, and adduction/abduction). Results: There were no statistically significant differences in the time spent for wrist movements across the three degrees of freedom throughout the study period. However, fellows spent significantly less time in extreme range (1.47 ± 0.34 min vs. 2.44 ± 0.34 min, P = 0.004) and center range (1.02 ± 0.34 min vs 1.9 ± 0.34 min, P = 0.01) at the end of the study compared to the baseline evaluation. The study was limited by the small number of subjects and performance of colonoscopies on a simulator rather than live patients. Conclusions: Gastroenterology trainees alter the time spent at the extreme range of wrist motion as they advance through training. Endoscopy training during the first 10 months of fellowship may have beneficial effects on learning ergonomically correct motion patterns. PMID:26716123

  12. At the ethical crossroads: how a gastroenterology procedure unit negotiated a solution for a reoccurring ethical dilemma.

    PubMed

    Gair, Jonathan

    2013-01-01

    The gastroenterology procedures environment has proven to be fertile ground for the realization of moral distress as it relates to the practice of nursing. Specifically, nurses are expected to fulfill their duty as advocates for their clients at all times and within all contexts; however, their ability to discharge this essential function has been complicated by such influential factors as sedating medications, competing ethical motivations, discordant conclusions of moral reasoning and action, as well as competing institutional factors. This article begins with a fictional case study to introduce readers to the contextual essence of the moral distress that a group of gastroenterology nurses was collectively experiencing. Subsequently, the aim of this article was to explicate how one department, with the aid of an ethics committee, negotiated a process similar to the case study to develop a pragmatic policy and identify an educational primer that encourages nurses to reexamine and value the tangible realities inherent and expected of an advocate in the dynamically complex environment that characterizes all gastroenterology procedure environments where gastroenterology nurses practice.

  13. American gastroenterological association medical position statement on treatment of patients with dysphagia caused by benign disorders of the distal esophagus.

    PubMed

    Spechler, S J

    1999-07-01

    This document presents the official recommendations of the American Gastroenterological Association (AGA) on treatment of patients with dysphagia caused by benign disorders of the distal espophagus. It was approved by the Clinical Practice and Practice Economics Committee on September 27, 1998, and by the AGA Governing Board on November 8, 1998.

  14. A nationwide survey of training satisfaction and employment prospects among Greek gastroenterology fellows during the economic recession

    PubMed Central

    Gkolfakis, Paraskevas; Tziatzios, Georgios; Papadopoulos, Vasilios; Dimitriadis, George D.; Georgopoulos, Sotirios D.; Triantafyllou, Konstantinos

    2017-01-01

    Background This study assessed Greek gastroenterology fellows’ satisfaction regarding training, working conditions, quality of life and future employment perspectives. Methods Greek gastroenterology fellows completed an anonymous multiple-choice electronic questionnaire designed to rate their satisfaction using a five-step Likert scale in two major domains: 1) fellowship program (training, working conditions, research activity, acquisition of endoscopic competencies, quality of life); and 2) professional expectations. Pareto analysis was used to determine the factors that had the most negative effect on fellows’ satisfaction. Results In 2016, over a two-month period, 121 invitations were distributed and 70 (58%) fellows responded. Overall, responders reported a low level of satisfaction with their training programs: the mean total satisfaction score was 42.94±11.55 (range 15-75). Pareto analysis revealed that the main factors negatively affecting satisfaction were financial remuneration, routine or menial work, and uncertainty about professional future (98.6%, 94.3% and 92.9% unfavorable answers, respectively). Of the total participants, 53% felt tired or very tired and 44.3% of them reported high levels of stress following a normal working day. Although the majority of the fellows did not regret choosing gastroenterology fellowship training, 34.4% of them would choose a different training environment, if possible. Conclusion Our study revealed that Greek gastroenterology fellows are dissatisfied with their training programs and with their professional perspectives. It also detected the issues that contribute most to this unfavorable outcome. PMID:28243047

  15. [Gastroenterology 2.0: useful resources for the gastroenterologist available on the Web 2.0].

    PubMed

    Curioso, Walter H; Proaño, Alvaro; Ruiz, Eloy F

    2011-01-01

    The term Web 2.0 refers to the use of Internet applications which enable the users to share, participate and collaborate together on information. The objective of this study is to check different applications that use Web 2.0, which could help the gastroenterologist in his daily practice. The applications that will be checked include: blogs, microblogging, RSS, podcasts, wikis and social networks. "Gastroenterology 2.0" represents the applications, services, and tools based on Web 2.0, which are of easy use and easily accessible - to consumers, patients, gastroenterologists and other health professionals, as well as researchers. Although several studies have shown the benefits these technologies have on the medical practice, it is necessary to conduct further studies to demonstrate the use of these applications on improving health.

  16. Integral scale histogram local binary patterns for classification of narrow-band gastroenterology images.

    PubMed

    Riaz, Farhan; Ribeiro, Mario-Dinis; Pimentel-Nunes, Pedro; Coimbra, Miguel Tavares

    2013-01-01

    The introduction of various novel imaging technologies such as narrow-band imaging have posed novel image processing challenges to the design of computer assisted decision systems. In this paper, we propose an image descriptor referred to as integrated scale histogram local binary patterns. We propagate an aggregated histogram of local binary patterns of an image at various resolutions. This results in low dimensional feature vectors for the images while incorporating their multiresolution analysis. The descriptor was used to classify gastroenterology images into four distinct groups. Results produced by the proposed descriptor exhibit around 92% accuracy for classification of gastroenteroloy images outperforming other state-of-the-art methods, endorsing the effectiveness of the proposed descriptor.

  17. Patient Electronic Health Records as a Means to Approach Genetic Research in Gastroenterology

    PubMed Central

    Ananthakrishnan, Ashwin N; Lieberman, David

    2015-01-01

    Electronic health records (EHR) are being increasingly utilized and form a unique source of extensive data gathered during routine clinical care. Through use of codified and free text concepts identified using clinical informatics tools, disease labels can be assigned with a high degree of accuracy. Analysis linking such EHR-assigned disease labels to a biospecimen repository has demonstrated that genetic associations identified in prospective cohorts can be replicated with adequate statistical power, and novel phenotypic associations identified. In addition, genetic discovery research can be performed utilizing clinical, laboratory, and procedure data obtained during care. Challenges with such research include the need to tackle variability in quality and quantity of EHR data and importance of maintaining patient privacy and data security. With appropriate safeguards, this novel and emerging field of research offers considerable promise and potential to further scientific research in gastroenterology efficiently, cost-effectively, and with engagement of patients and communities. PMID:26073373

  18. Biofluid metabonomics using (1)H NMR spectroscopy: the road to biomarker discovery in gastroenterology and hepatology.

    PubMed

    Patel, Neeral R; McPhail, Mark J W; Shariff, Mohamed I F; Keun, Hector C; Taylor-Robinson, Simon D

    2012-04-01

    Metabolic profiling or 'metabonomics' is an investigatory method that allows metabolic changes associated with the presence of an underlying pathological process to be investigated. Various biofluids can be utilized in the process but urine, serum and fecal extract are most pertinent to the investigation of gastrointestinal and hepatological disease. Nuclear magnetic resonance spectroscopy-based metabonomic research has the potential to generate novel noninvasive diagnostic tests, based on biomarkers of disease, which are simple and cost effective yet retain high sensitivity and specificity characteristics. The process involves a number of key steps, including sample collection, data acquisition, chemometric techniques and, finally, validation. This technique-driven review aims to demystify the metabonomics pathway, while also illustrating the potential of this technique with recent examples of its application in hepato-gastroenterological disease.

  19. Human stem-cell research in gastroenterology: experimental treatment, tourism and biobanking.

    PubMed

    Hermerén, Göran

    2014-04-01

    The growing interest in the possibility of applying stem-cell therapies to gastroenterological diseases is outlined. Some promising results have been reported, but more research is needed in view of the uncertainties and knowledge gaps that still exist. The ethical issues raised by this kind of research are then indicated and classified. Three problematic kinds of situation are outlined: experimental treatments, stem-cell tourism and biobanking. A four-question approach - which is not to be confused with the well-known four-principle approach introduced by Beauchamp and Childress - is described and applied to these three challenging situations. In conclusion, it is pointed out that the analysis of these situations illustrates the interplay between definitions, empirical research and ethics. They are interrelated and need to be integrated.

  20. Society of Gastroenterology Nurses and Associates, Inc. (SGNA) Endoscopic Disinfectant Survey results compared with control group.

    PubMed

    Ellett, M L; Fullhart, J W; Wright, K B

    1996-01-01

    Disinfectant surveys from responding members of the American Society of Postanesthesia Nurses were divided into two groups based on whether or not they considered themselves to be exposed to disinfectants in their work environment. Their survey responses were then compared with those obtained previously from members of the Society of Gastroenterology Nurses and Associates, Inc., who were regularly exposed to 2% alkaline glutaraldehyde in the work setting. There were significant differences among the groups in the percentage of respondents who reported having headaches, eye irritations, respiratory problems, shortness of breath, rashes, memory loss, mood swings, and fatigue. These findings support the association of these complaints with 2% alkaline glutaraldehyde exposure. In contrast, there were no significant differences among the groups in the percentage of respondents who reported having asthma, rhinitis, chest pain, nausea, diarrhea, muscle/joint pain, visual disturbances, or dermatitis.

  1. Download Alert: Understanding Gastroenterology Patients' Perspectives on Health-Related Smartphone Apps

    PubMed Central

    Zia, Jasmine K; Le, Thai; Munson, Sean; Heitkemper, Margaret M; Demiris, George

    2015-01-01

    Objectives: The aims of this study were to understand patients' willingness to use different types of health-related smartphone apps and to explore their attitudes on the overall value, usability, feasibility, credibility, intrusiveness, and obtrusiveness of these apps. Methods: Questionnaires were distributed to adult patients presenting to gastroenterology clinics at an academic medical center. The 25-question survey consisted of 5-point Likert-type scale statements, multiple-choice questions, and open-ended questions. Results: Participants were mainly White (N=94, 78%) and smartphone owners (N=125, 93%). The mean age was 40.8 years (N=121, s.d.=13.2). Participants were willing to use most types of apps unless it monitored their location or social networking activity. Half were less willing to use an app if it required a visible accessory. Most participants were willing to use a health-related app up to 5 min a day indefinitely but unwilling to pay out-of-pocket for it. Participants generally disagreed that an app would be hard to learn how to use, interfere with their daily routine, or be embarrassing to use in public. Overall, participants felt that health-related apps could help them and their doctors better manage their medical problems, but were neutral in trusting their quality. Most worried that personal information used for an app would fall into the wrong hands. Conclusion: Gastroenterology patients were willing to use and valued most types of health-related apps. They perceived this technology as feasible, usable, and relatively unobtrusive unless a visible accessory was required. However, many were concerned about their privacy. PMID:26133109

  2. Improvement analysis of article quality in World Journal of Gastroenterology during 2008-2012.

    PubMed

    Yang, Hua; Chen, Yun-Xiang

    2013-11-28

    To understand the changes and development of World Journal of Gastroenterology (WJG) in recent years. The Journal Citation Report (JCR) and SCI-E database of the ISI Web of Knowledge were used to search the articles and data of related indices in WJG during 2008-2012. Bibliometric methods were used for statistical analysis of the author's degree of collaboration, collaboration rate, the first author's publications, high-productivity authors, the authors' origins in each year; the distribution of the countries and journals of the authors citing WJG papers was also analyzed. In addition, the indices related to this journal in each year were compared with the data from 6 SCI journals in the field of gastroenterology in the 2012 volume. A total of 4409 papers in WJG were examined in this study. For the period 2008-2012, the self-citation rate was 8.59%, 6.02%, 5.50%, 4.47% and 5.21%. Of a total of 3898 first authors, 3526 published 1 paper, 291 published 2 papers, 59 published 3 papers, and 22 published 4 or more papers. The origin of WJG authors covered the six continents, and the majority came from Asia, Europe and North America. The number of countries of origin of WJG authors was 65, 66, 61, 65 an 60 for the period 2008-2012. Authors from 66 countries cited a total of 3194 of the 4409 papers, and these citations were found in 1140 journals. The results suggest that WJG has stayed on the track of normal international publication and all the indices of this journal are stable and reasonable.

  3. Bone Health in a Tertiary-Care Gastroenterology and Hepatology Population

    PubMed Central

    Thiny, Michelle T.; Sandler, Robert S.; Gangarosa, Lisa M.

    2010-01-01

    Background Glucocorticoid use is a major risk factor for osteoporosis. Overall rates of glucocorticoid use and bone health preventive measures in gastroenterology and hepatology populations are unknown. Aims We aimed to determine rates of glucocorticoid use and bone health preventive measures, to evaluate an education-based quality improvement initiative on bone health, and to assess improvement in health care practices of providers in regards to bone health recommendations. Methods A cross-sectional survey was offered to all patients visiting a tertiary care gastroenterology and hepatology clinic. A bone health education intervention was performed, followed by a repeat cross-sectional survey. Pearson’s chi square test statistic was used to evaluate interval improvement in bone health recommendations with the intervention. Predictive multiple logistic regression modeling was used to determine factors that influenced bone health recommendations by providers. Results A total of 552 patients and 725 patients completed the pre and post-intervention questionnaires respectively. The prevalence of glucocorticoid use was 12.9%. Bone health recommendations to patients on glucocorticoids did not improve with the intervention (63.0% vs.55.4%, p=0.42). The strongest predictor of bone health recommendations was autoimmune hepatitis (OR 6.60 95% CI 3.13, 13.90), followed by inflammatory bowel disease (OR 6.06 95%CI 3.92, 9.38), liver disease (OR 3.70 95% CI 2.45, 5.59), current smoking (OR 3.31 95% CI 2.32, 4.73) and history of osteoporosis/osteopenia (OR 2.72 95% CI 1.83, 4.03). Conclusions In spite of risk factors for osteoporosis in patients with digestive diseases, health care practices by providers in regards to bone health recommendations warrant further improvement. PMID:20127169

  4. Adherence to oral chemotherapy medications among gastroenterological cancer patients visiting an outpatient clinic.

    PubMed

    Hirao, Chieko; Mikoshiba, Naoko; Shibuta, Tomomi; Yamahana, Reiko; Kawakami, Aki; Tateishi, Ryosuke; Yamaguchi, Hironori; Koike, Kazuhiko; Yamamoto-Mitani, Noriko

    2017-09-01

    The purpose of this study was to investigate medication adherence to oral chemotherapy medications and determinants of medication non-adherence to them among gastroenterological cancer patients. A cross-sectional study was conducted on 117 consecutive, consenting, eligible patients visiting an outpatient clinic of university hospital in Japan. Good medication adherence was defined as taking 100% of the prescribed dose. Medication adherence was measured via self-report. We hypothesized that there was a significant relationship between medication non-adherence and the five factors defined by the World Health Organization: patient-related, socioeconomic-related, condition-related, treatment-related, and healthcare-system/provider-related factors. Multiple logistic regression models were used to identify factors associated with oral chemotherapy medication non-adherence. The proportion of patients showing good medication adherence was 56.4%. The multiple logistic regression analysis revealed that the determinants of medication non-adherence to oral chemotherapy medications included having a history of patient-caused treatment interruptions due to worsening of symptoms (adjusted odds ratio [AOR] = 9.59, 95% confidence interval [CI] = 1.38-66.47), having diarrhea (AOR = 3.25, 95% CI = 1.13-9.34), experiencing pain (AOR = 0.17, 95% CI = 0.05-0.55), taking oral chemotherapy medication every 8 h (AOR = 5.52, 95% CI = 1.71-17.81), and diminished sense of priority for medication (AOR = 1.40, 95% CI = 1.21-1.63). This study suggests that many patients with gastroenterological cancer were non-adherent to oral chemotherapy medications. It might be necessary to conduct periodic screening and connect patients at a high risk of medication non-adherence to appropriate support.

  5. Establishing an integrated gastroenterology service between a medical center and the community.

    PubMed

    Niv, Yaron; Dickman, Ram; Levi, Zohar; Neumann, Gadi; Ehrlich, Dorit; Bitterman, Haim; Dreiher, Jacob; Cohen, Arnon; Comaneshter, Doron; Halpern, Eyran

    2015-02-21

    To combine community and hospital services in order to enable improvements in patient management, an integrated gastroenterology service (IGS) was established. Referral patterns to specialist clinics were optimized; open access route for endoscopic procedures (including esophago-gastro-duodenoscopy, sigmoidoscopy and colonoscopy) was established; family physicians' knowledge and confidence were enhanced; direct communication lines between experts and primary care physicians were opened. Continuing education, guidelines and agreed instructions for referral were promoted by the IGS. Six quality indicators were developed by the Delphi method, rigorously designed and regularly monitored. Improvement was assessed by comparing 2010, 2011 and 2012 indicators. An integrated delivery system in a specific medical field may provide a solution to a fragmented healthcare system impaired by a lack of coordination. In this paper we describe a new integrated gastroenterology service established in April 2010. Waiting time for procedures decreased: 3 mo in April 30th 2010 to 3 wk in April 30th 2011 and stayed between 1-3 wk till December 30th 2012. Average cost for patient's visit decreased from 691 to 638 NIS (a decrease of 7.6%). Six health indicators were improved significantly comparing 2010 to 2012, 2.5% to 67.5%: Bone densitometry for patients with inflammatory bowel disease, preventive medications for high risk patients on aspirin/NSAIDs, colonoscopy following positive fecal occult blood test, gastroscopy in Barrett's esophagus, documentation of family history of colorectal cancer, and colonoscopy in patients with a family history of colorectal cancer. Establishment of an IGS was found to effectively improve quality of care, while being cost-effective.

  6. Practice Audit in Gastroenterology (PAGE) program: A novel approach to continuing professional development

    PubMed Central

    Armstrong, David; Hollingworth, Roger; Gardiner, Tara; Klassen, Michael; Smith, Wendy; Hunt, Richard H; Barkun, Alan; Gould, Michael; Leddin, Desmond

    2006-01-01

    BACKGROUND: Practice audit is an important component of continuing professional development that may more readily be undertaken if it were less complex. This qualitative study assessed the use of personal digital assistants to facilitate data collection and review. METHODS: Personal digital assistants programmed with standard questionnaires related to upper gastrointestinal endoscopies (Practice Audit in Gastroenterology-Endoscopy [‘PAGE-Endo’]) and colonoscopies (PAGE-Colonoscopy [‘PAGE-Colo’]) were provided to Canadian gastroenterologists, surgeons and internists. Over a three-week audit period, participants recorded indications, and the expected (E) and reported (R) findings for each procedure. Thereafter, participants recorded compliance with reporting, the ease of use and value of the PAGE program, and their willingness to perform another audit. RESULTS: Over 15 to 18 months, 173 participants completed PAGE-Endo (6168 procedures) and 111 completed PAGE-Colo (4776 procedures). Most respondents noted that PAGE was easy to use (99%), beneficial (88% to 95%), and that they were willing undertake another audit (92% to 95%). In PAGE-Endo, alarm features were prevalent (55%), but major reported findings were less common than expected: esophagitis (E 29.9%, R 14.8%), esophageal stricture (E 8.3%, R 3.6%), gastric ulcer (E 17.0%, R 4.7%), gastric cancer (E 4.3%, R 1.0%) and duodenal ulcer (E 11.5%, R 5.7%). In PAGE-Colo, more colonoscopies were performed for symptom investigation (55%) than for screening (25%) or surveillance (20%). There were marked interprovincial variations with respect to sedation, biopsies and technical aspects of colonoscopy. CONCLUSION: Secure, real-time data entry with review of aggregate and individual data in the PAGE program provided an acceptable, straightforward methodology for accredited practice audit activities. PAGE has considerable potential for continuing professional development in gastroenterology and other specialties

  7. A 25-year analysis of the American College of Gastroenterology Research Grant Program:

    PubMed Central

    Crockett, Seth D.; Dellon, Evan S.; Bright, Stephanie D.; Shaheen, Nicholas J.

    2011-01-01

    Introduction The American College of Gastroenterology (ACG) has awarded research grants for 25 years. We assessed the characteristics of grant recipients, their current academic status, and the likelihood of publication resulting from the grant. Methods Demographic data, year and amount of award, title of project, and recipient’s institution were extracted from ACG databases. Using ACG reports and medical literature search engines, we assessed publication based on grant-funded research, as well as career publication record. We also determined the current position of awardees. Similar analysis was performed for recipients of junior investigator awards. Results A total of 396 clinical research awards totaling $5,374,497 ($6,867,937 in 2008 dollars) were awarded to 341 recipients in the 25 years between 1983 and 2008. The most commonly funded areas of research were endoscopy (22% of awards) and motility/functional disorders (21%). At least one peer-reviewed publication based on grant-funded research occurred in 255 of the awards (69%). Higher award value was associated with subsequent publication. Of 341 past awardees, 195 (62%) are currently in academic positions. Factors associated with staying in academics included higher award value (p<0.01), a Master’s degree (p=0.02) and publishing grant-funded research (p<0.01). The junior faculty career development award was granted to 27 individuals for a total of $3,000,000 (3,398,004 in 2008 dollars). Publication resulted from 90% of the funded projects, and 95% of awardees have remained in academics. Overall, the mean cost in grant dollars per published paper based on the research was $14,875. Conclusion The majority of ACG grant recipients published the results of their research and remained in academics. Higher amount of award, holding an advanced degree, and publication were associated with careers in academics. The ACG research grant award program is an important engine of investigation, publications, and academic

  8. [Consumption of medicinal herbs in patients attending a gastroenterology outpatient clinic].

    PubMed

    Devesa Jordà, F; Pellicer Bataller, J; Ferrando Ginestar, J; Borghol Hariri, A; Bustamante Balén, M; Ortuño Cortés, J; Ferrando Marrades, I; Llobera Bertran, C; Sala Lajo, A; Miñana Morell, M; Nolasco Bonmatí, A; Fresquet Febrer, J L

    2004-04-01

    The consumption of medicinal herbs is one of the most important topics in alternative and complementary medicine. The widespread use of these substances among the general population gives rise to the possibility of therapeutic or toxic effects in patients seeking conventional medical assistance. To determine the frequency of medicinal herb use, the species consumed and the profile of medicinal herb consumers among patients with gastrointestinal disorders, patients attending the gastroenterology outpatient clinic of the Francesc de Borja district hospital (Gandía, Spain) over a 5-month period were interviewed and 539 valid questionnaires were obtained. A total of 34.7% of the interviewees had taken medicinal herbs at some time and 26.9% had used them in the last year. Self-prescription was reported by 67.1%. Medicinal herbs were mainly obtained in the pharmacy or herbalist's (74.7%). The results of medicinal herb therapy were considered good or excellent by 80.3% of the interviewees, average by 18.6% and poor by 1.1%. In the univariate analysis, medicinal herb consumption was positively associated with female sex (p < 0.001), a university education (p < 0.05), consumption of psychotropic drugs (p < 0.005), use of trencar l'enfit (TE, a common practice of magic medicine in Valencia) (p < 0.001), functional gastrointestinal disorders (p < 0.005) and a diagnosis of lower gastrointestinal disorder (p < 0.01). In the multivariate analysis, the variables that remained statistically significant were female sex (p < 0.005), university education (p < 0.01), use of TE and a diagnosis of lower gastrointestinal disorder. Fifty-seven botanical varieties were used. The most frequent varieties were Santolina chamaecyparissus (18.8%), Tilia platyphyllos (6.5%), Thymus vulgaris (6%), Equisetum ramosissimum (4.7%), Mentha pulegium (4.4%) and Valeriana officinalis (4.4%). The results show that consumption of medicinal herbs is frequent among patients attending the gastroenterology

  9. Papers featured in the World Journal of Gastroenterology from 2006 to 2007.

    PubMed

    Yang, Hua; Zhang, Jing-Hai; Zhang, Fang

    2009-09-21

    To analyze papers published in the World Journal of Gastroenterology (WJG) from 2006 to 2007. We investigated the highly cited papers for geographic distribution of the cited authors, as well as the distribution of the citing journals and year of citation. Papers published in WJG from 2006 to 2007 and their citations were retrieved from the Science Citation Index Expanded (SCIE). The papers and their citations were analyzed according to bibliometric methods, including the number of citations for a given paper, the distribution of the highly cited papers, the geographic distribution of the cited authors, and the years of citation. Two thousand five hundred and six papers published in WJG from 2006 to 2007 were collected through SCIE, and 2335 of these were categorized as articles, reviews or proceedings. In 2006 and 2007, the average citation rate was 85.08% and 70.48%, respectively, and the average number of citations per paper was 4.33 and 2.51. Among the 2506 papers, 1963 were cited 8788 times by other articles. The mean number of citations per paper was 3.51. The papers with over three citations accounted for 54.72% of all those that were cited, and the total number of citations accounted for 85.38% of the total of 8788 citations. Thirteen papers were cited over 30 times and the highest number of citations for any one paper was 98. The cited authors came from 70 different countries or regions, with China, Japan and the United States being the most frequent. The highest average citation rate and number of citations per paper were for authors from Canada (96.30%, 6.89), Hungary (92.31%, 5.62), Australia (88.46%, 5.46), Germany (87.04%, 5.33), and Spain (87.50%, 5.11). The impact factor was 2.081 and the self-citation rate was 9.41% in 2008. The papers published in WJG in 2006-2007 were cited by 1597 journals. The papers in WJG have a high number of citations, and have been cited in numerous journals by authors from various countries. The results imply that WJG has

  10. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition syllabus for subspecialty training: moving towards a European standard.

    PubMed

    D'Antiga, Lorenzo; Nicastro, Emanuele; Papadopoulou, Alexandra; Mearin, Maria L; Tzivinikos, Christos; Vandenplas, Yvan; van Goudoever, Hans; Baumann, Ulrich; Troncone, Riccardo; Koletzko, Berthold

    2014-09-01

    The requirements for and conditions of subspecialty training in paediatric gastroenterology, hepatology, and nutrition (PGHN) are rather variable across European countries. The European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) agreed on a training syllabus aimed to foster a harmonised European PGHN curriculum and to support national PGHN societies and governmental bodies to promote and establish high-quality training programmes and levels of certification in the field. The document provides PGHN training prerequisites and objectives and the basic knowledge elements to acquire the clinical, technical, and management skills needed. Guidelines and instruments for self-monitoring and appraisal are proposed, and a logbook is available online. These training standards are a first step towards a European certification and recognition as a specialist in PGHN.

  11. Paediatric gastroenterology evaluation of overweight and obese children referred from primary care for suspected non-alcoholic fatty liver disease.

    PubMed

    Schwimmer, J B; Newton, K P; Awai, H I; Choi, L J; Garcia, M A; Ellis, L L; Vanderwall, K; Fontanesi, J

    2013-11-01

    Screening overweight and obese children for non-alcoholic fatty liver disease (NAFLD) is recommended by paediatric and endocrinology societies. However, gastroenterology societies have called for more data before making a formal recommendation. To determine whether the detection of suspected NAFLD in overweight and obese children through screening in primary care and referral to paediatric gastroenterology resulted in a correct diagnosis of NAFLD. Information generated in the clinical evaluation of 347 children identified with suspected NAFLD through screening in primary care and referral to paediatric gastroenterology was captured prospectively. Diagnostic outcomes were reported. The diagnostic performance of two times the upper limit of normal (ULN) for alanine aminotransferase (ALT) was assessed. Non-alcoholic fatty liver disease was diagnosed in 55% of children identified by screening and referral. Liver disease other than NAFLD was present in 18% of those referred. Autoimmune hepatitis was the most common alternative diagnosis. Children with NAFLD had significantly (P < 0.05) higher screening ALT (98 ± 95) than children with liver disease other than NAFLD (86 ± 74). Advanced fibrosis was present in 11% of children. For the diagnosis of NAFLD, screening ALT two times the clinical ULN had a sensitivity of 57% and a specificity of 71%. Screening of overweight and obese children in primary care for NAFLD with referral to paediatric gastroenterology has the potential to identify clinically relevant liver pathology. Consensus is needed on how to value the risk and rewards of screening and referral, to identify children with liver disease in the most appropriate manner. © 2013 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.

  12. Assessing the educational needs of Canadian gastroenterologists and gastroenterology nurses: Challenges to optimal care in Crohn’s disease

    PubMed Central

    Dupuis, Martin; Marshall, John K; Hayes, Sean M; Cytryn, Kayla; Murray, Suzanne

    2009-01-01

    OBJECTIVE: A national needs assessment of Canadian gastroenterologists and gastroenterology nurses was undertaken to determine the perceived and unperceived educational and performance barriers to caring for patients with Crohn’s disease (CD). METHODS: A triangulated, mixed-method approach (qualitative and quantitative) was used to determine the nature and extent of knowledge gaps and barriers in the care of patients with CD. RESULTS: Qualitative interviews were conducted with nine gastroenterologists, four gastroenterology nurses and nine patients with CD. Based on this exploratory research, a survey was designed and launched nationally (37 gastroenterologists, 36 gastroenterology nurses). Findings indicated that Canadian gastroenterologists and gastroenterology nurses lacked clarity regarding their roles and responsibilities across the continuum of CD care, and face communication gaps within the health care team, undermining their effectiveness. Gastroenterologists identified challenges in optimal diagnosis due to unclear testing and diagnostic criteria. They recognized knowledge gaps when treating patient subgroups and in prescribing biological therapies. Furthermore, gastroenterologists self-identified gaps in skill, knowledge, and confidence in monitoring disease progression and effectively assessing response to therapy. When managing patients with CD, gastroenterologists expressed challenges with patient issues outside their domain of medical expertise, particularly with the skills needed to facilitate effective patient communication and education that would enhance adherence to recommended treatments. CONCLUSIONS: Educational initiatives should address diagnostic and treatment guidelines, as well as enhancement of clinical performance gaps in health care team processes and the patient-professional therapeutic relationship. To impact care and patient outcomes, these initiatives must be relevant to clinical practice settings and applicable to the practice

  13. Paediatric gastroenterology evaluation of overweight and obese children referred from primary care for suspected non-alcoholic fatty liver disease

    PubMed Central

    Schwimmer, J B; Newton, K P; Awai, H I; Choi, L J; Garcia, M A; Ellis, L L; Vanderwall, K; Fontanesi, J

    2013-01-01

    Background Screening overweight and obese children for non-alcoholic fatty liver disease (NAFLD) is recommended by paediatric and endocrinology societies. However, gastroenterology societies have called for more data before making a formal recommendation. Aim To determine whether the detection of suspected NAFLD in overweight and obese children through screening in primary care and referral to paediatric gastroenterology resulted in a correct diagnosis of NAFLD. Methods Information generated in the clinical evaluation of 347 children identified with suspected NAFLD through screening in primary care and referral to paediatric gastroenterology was captured prospectively. Diagnostic outcomes were reported. The diagnostic performance of two times the upper limit of normal (ULN) for alanine aminotransferase (ALT) was assessed. Results Non-alcoholic fatty liver disease was diagnosed in 55% of children identified by screening and referral. Liver disease other than NAFLD was present in 18% of those referred. Autoimmune hepatitis was the most common alternative diagnosis. Children with NAFLD had significantly (P < 0.05) higher screening ALT (98 ± 95) than children with liver disease other than NAFLD (86 ± 74). Advanced fibrosis was present in 11% of children. For the diagnosis of NAFLD, screening ALT two times the clinical ULN had a sensitivity of 57% and a specificity of 71%. Conclusions Screening of overweight and obese children in primary care for NAFLD with referral to paediatric gastroenterology has the potential to identify clinically relevant liver pathology. Consensus is needed on how to value the risk and rewards of screening and referral, to identify children with liver disease in the most appropriate manner. PMID:24117728

  14. Specific 13C functional pathways as diagnostic targets in gastroenterology breath-tests: tricks for a correct interpretation.

    PubMed

    Pizzoferrato, M; Del Zompo, F; Mangiola, F; Lopetuso, L R; Petito, V; Cammarota, G; Gasbarrini, A; Scaldaferri, F

    2013-01-01

    Breath tests are non-invasive, non-radioactive, safe, simple and effective tests able to determine significant metabolic alterations due to specific diseases or lack of specific enzymes. Carbon isotope (13)C, the stable-non radioactive isotope of carbon, is the most used substrate in breath testing, in which (13)C/(12)C ratio is measured and expressed as a delta value, a differences between readings and a fixed standard. (13)C/(12)C ratio is measured with isotope ratio mass spectrometry or non-dispersive isotope-selective infrared spectrometer and generally there is a good agreement between these techniques in the isotope ratio estimation. (13)C/(12)C ratio can be expressed as static measurement (like delta over baseline in urea breath test) or as dynamic measurement as percent dose recovery, but more dosages are necessary. (13)C Breath-tests are involved in many fields of interest within gastroenterology, such as detection of Helicobacter pylori infection, study of gastric emptying, assessment of liver and exocrine pancreatic functions, determination of oro-caecal transit time, evaluation of absorption and to a lesser extend detection of bacterial overgrowth. The use of every single test in a clinical setting is vary depending on accuracy and substrate costs. This review is meant to present (13)C the meaning of (13)C/(12)C ratio and static and dynamic measure and, finally, the instruments dedicated to its use in gastroenterology. A brief presentation of (13)C breath tests in gastroenterology is also provided.

  15. Genomic medicine in gastroenterology: A new approach or a new specialty?

    PubMed Central

    Roman, Sonia; Panduro, Arturo

    2015-01-01

    Throughout history, many medical milestones have been achieved to prevent and treat human diseases. Man’s early conception of illness was naturally holistic or integrative. However, scientific knowledge was atomized into quantitative and qualitative research. In the field of medicine, the main trade-off was the creation of many medical specialties that commonly treat patients in advanced stages of disease. However, now that we are immersed in the post-genomic era, how should we reevaluate medicine? Genomic medicine has evoked a medical paradigm shift based on the plausibility to predict the genetic susceptibility to disease. Additionally, the development of chronic diseases should be viewed as a continuum of interactions between the individual’s genetic make-up and environmental factors such as diet, physical activity, and emotions. Thus, personalized medicine is aimed at preventing or reversing clinical symptoms, and providing a better quality of life by integrating the genetic, environmental and cultural factors of diseases. Whether using genomic medicine in the field of gastroenterology is a new approach or a new medical specialty remains an open question. To address this issue, it will require the mutual work of educational and governmental authorities with public health professionals, with the goal of translating genomic medicine into better health policies. PMID:26217074

  16. Intestinal parasitic infestation in pediatric gastroenterology outpatient clinic Dr. Pirngadi Hospital Medan.

    PubMed

    Yusuf, R; Siregar, C D; Sinuhaji, A B; Sutanto, A H

    1991-01-01

    A retrospective study had been done at the outpatient clinic sub division of Pediatric Gastroenterology, Dr. Pirngcdi Hospital Medan, comprising patients from 1 January 1985-31 December 1987. There were 874 patients. Three hundred seventy eight (43.25%) patients consisting of 210 (55.56%) males and 168 (44.44%) females had intestinal parasitic infestations. The youngest patient was 5 months and the oldest was 14 years and 3 months. Ascaris lumbricoides was found in 215 patients (24.60%) while Trichuris trichiura, hookworm, Oxyuris vermicularis, Hymenolepis nana, and Taenia were in 152 (17.39%), 13 (1.49%), 4 (0.46%), 15 (1.72%) and 4 (0.46%) cases respectively. Entamoeba histolytica was found in 121 (13.84%) and Giardia lamblia in 16 (1.83%) patients. The highest age specific attack rate was found in the age group of 5-10 years (65.67%). Ascaris lumbricoides was most frequently found namely in 100 children (26.46%), followed by Entameba histolytica in 73 (19.31%) and mixed infestation of Ascaris lumbricoides and Trichuris trichiura in 68 (17.99%) patients. One hundred seventy three (66.28%) under five patients with intestinal parasitic infestation had malnutrition while of the 433 under fives without intestinal parasitic infestation only 201 (46.42%) suffered from malnutrition (P less than 0.001).

  17. The Technical Quality of Delivered Care for People with Inflammatory Bowel Disease in Tabriz Gastroenterology Clinics

    PubMed Central

    Tabrizi, Jafar Sadegh; Somi, Mohammad Hossein; Asghari, Sima; Asghari Jafarabadi, Mohammad; Gharibi, Farid; Alidoost, Saeideh

    2015-01-01

    Background: The Inflammatory Bowel Disease (IBD) is considered as one of the chronic diseasesre-quiring complicated treatment. This study aimed to assess technical quality of providing care for pa-tients with IBD. Methods: This cross-sectional study was conducted on 94 people with IBD using interviews and simple random sampling methods in Gastroenterology, Endoscopy and clinic of Imam Reza Hospital and Golgasht Clinic in Tabriz in 2012. The data collection tool was a researcher-designed questionnaire whose validity and reliability had been confirmed. In order to investigate the statistical relationship between the background variables and compliance with the standards the Chi-square test was applied using SPSS 17 Software. Results: "visit by the physician" and "diet advice by the dietitian" have had the highest and the lowest levels of compliance with the standard respectively, and "the care related to the disease exacerbation" and "the care provided by the other physicians" were not compatible with the standards in 80% of the cases. Data analyses also showed that there was a significant relationship between participant’s age, job, education and the smoking status and compliance of some care with the relevant standards (P<0.05). Conclusion: The results indicate a substantial gap between provided care for the people with IBD and the relevant standards. This indicates the areas that need of improvement and requires the serious attention of the authorities. PMID:26634198

  18. Rifaximin and diverticular disease: Position paper of the Italian Society of Gastroenterology (SIGE).

    PubMed

    Cuomo, Rosario; Barbara, Giovanni; Annibale, Bruno

    2017-02-01

    Management of diverticular disease has significantly improved in the last decade. Antibiotic treatment is used for symptom relief and prevention of complications. In Italy, the non-absorbable antibiotic rifaximin is one of the most frequently used drugs, and it is perceived as the reference drug to treat symptomatic diverticular disease. Its non-systemic absorption and high faecal concentrations have oriented rifaximin use to the gastrointestinal tract, where rifaximin exerts eubiotic effects representing an additional value to its antibiotic activity. This position paper was commissioned by the Italian Society of Gastroenterology governing board for a panel of experts (RC, GB, BA) to highlight the indications for treatment of diverticular disease. There is a lack of rationale for drug use for the primary prevention of diverticulitis in patients with diverticulosis; thus, rifaximin use should be avoided. The cyclic use of rifaximin, in association with high-fibre intake, is safe and useful for the treatment of symptomatic uncomplicated diverticular disease, even if the cost-efficacy of long-term treatment remains to be determined. The use of rifaximin in the prevention of diverticulitis recurrence is promising, but the low therapeutic advantage needs to be verified. No evidence is available on the efficacy of rifaximin treatment on acute uncomplicated diverticulitis.

  19. Prevalence, Clinical Characteristics, and Management of Functional Constipation at Pediatric Gastroenterology Clinics

    PubMed Central

    Chang, Soo Hee; Park, Kie Young; Kang, Sung Kil; Kang, Ki Soo; Na, So Young; Yang, Hye Ran; Uhm, Ji Hyun

    2013-01-01

    The purpose of this study was to investigate the prevalence, clinical characteristics, and management of functional constipation at pediatric gastroenterology clinics. A prospective survey using the Rome III criteria was distributed to a group of parents of children with a constipation history and its control group in May 2008. The mean prevalence of constipation was 6.4%, which was similar to those in other countries. Statistically significant variables for children without constipation were that more children had a body mass index of below the 10th percentile even though they received more mother's care and ate balanced meals compared to the constipation group. Meanwhile, the constipation group frequently showed a history of constipation in infancy, picky-eating, lack of exercise, and retentive posturing. When analyzed with the Rome III criteria, the children showed greater than 60% rate of hard stools, painful stools, a history of large fecal mass in rectum, and its disappearance of constipation symptoms after passing a large stool. Our study found different approaches amongst pediatric gastroenterologists like rectal examinations, disimpaction, or drug treatment. Several factors addressed in our study can provide better guidelines for clinicians treating constipation and its future research. PMID:24015043

  20. [Antibiotic prophylaxis in gastrointestinal endoscopy--recommendations of the Austrian Society of Gastroenterology and Hepatology].

    PubMed

    Wewalka, F; Kapral, C; Brownstone, E; Homoncik, M; Renner, F

    2010-10-01

    The recommendations of the Austrian Society of Gastroenterology and Hepatology (ÖGGH) for antibiotic prophylaxis in gastrointestinal endoscopy of the year 2002 have been updated in accord with the recently published guidelines of the American Society of Gastrointestinal Endoscopy (ASGE) and the American Heart Association (AHA). Antibiotic prophylaxis for any endoscopic intervention to prevent infectious endocarditis is no longer necessary. Moreover, the prophylactic use of antibiotics for ERCP without biliary obstruction and ERCP with obstruction and a likelihood of complete drainage is no longer recommended. For ERCP with obstruction and anticipated incomplete drainage, a full course of antibiotics should be administered to prevent cholangitis. For the prevention of local infections antibiotics are useful prior to endoscopic puncturing, contrasting or drainage of cystic lesions as well as just before application of a PEG tube. In cirrhotic patients with GI bleeding antibiotic prophylaxis should be started as early as possible and be administered for several days. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Anal lesions presenting in a cohort of child gastroenterological examinations. Implications for sexual traumatic injuries.

    PubMed

    Rougé-Maillart, Clotilde; Houdu, Sora; Darviot, Estelle; Buchaillet, Céline; Baron, Céline

    2015-05-01

    The purpose of this study was to describe the anal lesions found in children during a pediatric gastroenterology consultation when the reason for the complaint was related to a digestive disease. This prospective descriptive study included 100 children under 15 years of age over a 13-month period, consulting due to digestive symptoms. The children were under 8 years old (90%) and 25% were under 3.1 years old. Constipation was the most frequent reason for consultation (69%). Fifty-one anal lesions were observed, of which 58.8% were anal fissures, 15.7% were skin tags and 5.8% were venous congestions related to straining. Anal fissures and skin tags were located at the median line, according to the clock-face method in supine position. No child had more than two anal lesions. No anal dilatation, sphincter hypotonia, anal scars, anal lacerations or bruises were found. The two most common anal lesions were anal fissures and skin tags. These anal lesions were mainly observed at the median line and were due to constipation. No cases of multiple anal lesions were found in terms of common digestive diseases. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  2. Management of Nonceliac Gluten Sensitivity by Gastroenterology Specialists: Data from an Italian Survey.

    PubMed

    Branchi, Federica; Ferretti, Francesca; Norsa, Lorenzo; Roncoroni, Leda; Conte, Dario; Bardella, Maria Teresa; Elli, Luca

    2015-01-01

    Nonceliac gluten sensitivity is syndrome characterized by symptoms disappearing after a gluten-free diet. Its existence is still argument of discussion among specialists. Our aim was to evaluate the knowledge about nonceliac gluten sensitivity among gastroenterology specialists. During October 2013 a questionnaire was sent through a medical newsletter to Italian gastroenterologists. Twelve questions investigated their knowledge on nonceliac gluten sensitivity, including their diagnostic and therapeutic approach. A total of 212 gastroenterologists filled in the questionnaire. The 98.6% were aware of the existence of a syndrome called "nonceliac gluten sensitivity" and 77% believe in its existence. However, only 56% gave a correct definition of the term. The majority of specialists diagnosed gluten sensitive patients and the number of diagnoses was not statistically different from that of celiac disease. Moreover, a gluten-free diet was prescribed by 64% of the specialists and among them the 73% noted an increase of gluten sensitive patients attending their outpatient services. Our study indicated that most of the specialists recognize nonceliac gluten sensitivity and prescribe gluten-free diet, although 44% of the specialists are not able to give its correct definition; underlining the necessity of medical education on this topic is needed.

  3. Management of Nonceliac Gluten Sensitivity by Gastroenterology Specialists: Data from an Italian Survey

    PubMed Central

    Branchi, Federica; Ferretti, Francesca; Norsa, Lorenzo; Roncoroni, Leda; Conte, Dario; Bardella, Maria Teresa; Elli, Luca

    2015-01-01

    Background and Aim. Nonceliac gluten sensitivity is syndrome characterized by symptoms disappearing after a gluten-free diet. Its existence is still argument of discussion among specialists. Our aim was to evaluate the knowledge about nonceliac gluten sensitivity among gastroenterology specialists. Methods. During October 2013 a questionnaire was sent through a medical newsletter to Italian gastroenterologists. Twelve questions investigated their knowledge on nonceliac gluten sensitivity, including their diagnostic and therapeutic approach. Results. A total of 212 gastroenterologists filled in the questionnaire. The 98.6% were aware of the existence of a syndrome called “nonceliac gluten sensitivity” and 77% believe in its existence. However, only 56% gave a correct definition of the term. The majority of specialists diagnosed gluten sensitive patients and the number of diagnoses was not statistically different from that of celiac disease. Moreover, a gluten-free diet was prescribed by 64% of the specialists and among them the 73% noted an increase of gluten sensitive patients attending their outpatient services. Conclusions. Our study indicated that most of the specialists recognize nonceliac gluten sensitivity and prescribe gluten-free diet, although 44% of the specialists are not able to give its correct definition; underlining the necessity of medical education on this topic is needed. PMID:26665005

  4. Pelvic floor complaints in gastroenterology practice: results of a survey in the netherlands

    PubMed Central

    Nicolai, Melianthe P J; Fidder, Herma H; Bekker, Milou D; Putter, Hein; Pelger, Rob C M; Elzevier, Henk W

    2012-01-01

    Objective The pelvic floor is an integrated structure; dysfunctions may lead to a wide range of symptoms, involving voiding, defecation and sexual functioning (SF). Functional symptoms such as constipation and lower abdominal pain are often caused by pelvic floor dysfunction (PFD), and they highly impact the quality of life. Multiple specialists are responsible for a specific part of the pelvic floor, but its treatment asks for a holistic approach. The authors are still unaware of gastroenterologists' knowledge on PFD or whether they are addressing pelvic floor complaints in their daily practice. Design A 42-itemed anonymous questionnaire was mailed to all 402 members of the Dutch Society of Gastroenterology (gastroenterologists and residents-in-training). Results 169 (42%) questionnaires were analysed. Most gastroenterologists address lower urinary tract symptoms in their history-taking, 92% in female patients and 84% in male patients. When patients indicate irritable bowel syndrome-like complaints, more than 60% of the physicians inquire about SF to their female patients, compared with 38% inquiries to male patients (p<0.001). A reason not to inquire about SF is a lack of knowledge about female and male sexuality (19% and 23%, respectively). Forty-six per cent of the respondents regard it rather important to receive more training on PFD in male patients versus 61% in female patients. Conclusion Awareness of PFD is not yet routinely integrated into the history taken by gastroenterologists. PMID:24124626

  5. Targeting the Human Microbiome With Antibiotics, Probiotics, and Prebiotics: Gastroenterology Enters the Metagenomics Era

    PubMed Central

    Preidis, Geoffrey A.; Versalovic, James

    2014-01-01

    Studies of metagenomics and the human microbiome will tremendously expand our knowledge of the composition of microbial communities in the human body. As our understanding of microbial variation and corresponding genetic parameters is refined, this information can be applied to rational remodeling or “tailoring” of human-associated microbial communities and their associated functions. Physiologic features such as the development of innate and adaptive immunity, relative susceptibilities to infections, immune tolerance, bioavailability of nutrients, and intestinal barrier function may be modified by changing the composition and functions of the microbial communities. The specialty of gastroenterology will be affected profoundly by the ability to modify the gastrointestinal microbiota through the rational deployment of antibiotics, probiotics, and prebiotics. Antibiotics might be used to remove or suppress undesirable components of the human microbiome. Probiotics can introduce missing microbial components with known beneficial functions for the human host. Prebiotics can enhance the proliferation of beneficial microbes or probiotics, to maximize sustainable changes in the human microbiome. Combinations of these approaches might provide synergistic and effective therapies for specific disorders. The human microbiome could be manipulated by such “smart” strategies to prevent and treat acute gastroenteritis, antibiotic-associated diarrhea and colitis, inflammatory bowel disease, irritable bowel syndrome, necrotizing enterocolitis, and a variety of other disorders. PMID:19462507

  6. Fecal Incontinence: Prevalence, Severity, and Quality of Life Data from an Outpatient Gastroenterology Practice

    PubMed Central

    Alsheik, Eva H.; Coyne, Thomas; Hawes, Sara K.; Merikhi, Laleh; Naples, Scott P.; Kanagarajan, Nandhakumar; Reynolds, James C.; Myers, Scott E.; Ahmad, Asyia S.

    2012-01-01

    Background. The prevalence of fecal incontinence varies tremendously as a result of inadequate data collection methods. Few office-based studies have assessed the prevalence of fecal incontinence and none have looked at modifiable risk factors or effect on quality of life. Design, Settings, Patients, and Main Outcome Measures. Five hundred patients who visited our inner city, university-based gastroenterology practice, were asked about symptoms of fecal incontinence. We also retrospectively reviewed 500 charts to identify the frequency of patient-physician reporting of fecal incontinence. Results. Of the 500 patients that were directly questioned, 58 (12%, 43 women, 15 men) admitted to fecal incontinence compared to 12 (2.4%) in the retrospective arm. Patients with fecal incontinence and loose/watery stool reported the lowest quality of life scores. While the average severity score was similar between men and women, women had a significantly lower average quality of life score (3.04 versus 2.51; P < 0.03). Conclusions. The identification of fecal incontinence increases when patients are directly questioned. Identifying and treating patients with loose stool is a potential strategy to improve quality of life in this patient population. In men and women with similar severity of fecal incontinence, women have a significantly lower quality of life. PMID:21960998

  7. Perceptions of the Inpatient Training Experience: A Nationwide Survey of Gastroenterology Program Directors and Fellows.

    PubMed

    Kumar, Navin L; Perencevich, Molly L; Trier, Jerry S

    2017-08-16

    Inpatient training is a key component of gastroenterology (GI) fellowship programs nationwide, yet little is known about perceptions of the inpatient training experience. To compare the content, objectives and quality of the inpatient training experience as perceived by program directors (PD) and fellows in US ACGME-accredited GI fellowship programs. We conducted a nationwide, online-based survey of GI PDs and fellows at the conclusion of the 2016 academic year. We queried participants about (1) the current models of inpatient training, (2) the content, objectives, and quality of the inpatient training experience, and (3) the frequency and quality of educational activities on the inpatient service. We analyzed five-point Likert items and rank assessments as continuous variables by an independent t test and compared proportions using the Chi-square test. Survey response rate was 48.4% (75/155) for PDs and a total of 194 fellows completed the survey, with both groups reporting the general GI consult team (>90%) as the primary model of inpatient training. PDs and fellows agreed on the ranking of all queried responsibilities of the inpatient fellow to develop during the inpatient service. However, fellows indicated that attendings spent less time teaching and provided less formal feedback than that perceived by PDs (p < 0.0001). PDs rated the overall quality of the inpatient training experience (p < 0.0001) and education on the wards (p = 0.0003) as better than overall ratings by fellows. Although GI fellows and PDs agree on the importance of specific fellow responsibilities on the inpatient service, fellows report experiencing less teaching and feedback from attendings than that perceived by PDs. Committing more time to education and assessment may improve fellows' perceptions of the inpatient training experience.

  8. Comparison of National Operative Mortality in Gastroenterological Surgery Using Web-based Prospective Data Entry Systems

    PubMed Central

    Anazawa, Takayuki; Paruch, Jennifer L.; Miyata, Hiroaki; Gotoh, Mitsukazu; Ko, Clifford Y.; Cohen, Mark E.; Hirahara, Norimichi; Zhou, Lynn; Konno, Hiroyuki; Wakabayashi, Go; Sugihara, Kenichi; Mori, Masaki

    2015-01-01

    Abstract International collaboration is important in healthcare quality evaluation; however, few international comparisons of general surgery outcomes have been accomplished. Furthermore, predictive model application for risk stratification has not been internationally evaluated. The National Clinical Database (NCD) in Japan was developed in collaboration with the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), with a goal of creating a standardized surgery database for quality improvement. The study aimed to compare the consistency and impact of risk factors of 3 major gastroenterological surgical procedures in Japan and the United States (US) using web-based prospective data entry systems: right hemicolectomy (RH), low anterior resection (LAR), and pancreaticoduodenectomy (PD). Data from NCD and ACS-NSQIP, collected over 2 years, were examined. Logistic regression models were used for predicting 30-day mortality for both countries. Models were exchanged and evaluated to determine whether the models built for one population were accurate for the other population. We obtained data for 113,980 patients; 50,501 (Japan: 34,638; US: 15,863), 42,770 (Japan: 35,445; US: 7325), and 20,709 (Japan: 15,527; US: 5182) underwent RH, LAR, and, PD, respectively. Thirty-day mortality rates for RH were 0.76% (Japan) and 1.88% (US); rates for LAR were 0.43% versus 1.08%; and rates for PD were 1.35% versus 2.57%. Patient background, comorbidities, and practice style were different between Japan and the US. In the models, the odds ratio for each variable was similar between NCD and ACS-NSQIP. Local risk models could predict mortality using local data, but could not accurately predict mortality using data from other countries. We demonstrated the feasibility and efficacy of the international collaborative research between Japan and the US, but found that local risk models remain essential for quality improvement. PMID:26656350

  9. Pediatric gastrointestinal bleeding: Perspectives from the Italian Society of Pediatric Gastroenterology

    PubMed Central

    Romano, Claudio; Oliva, Salvatore; Martellossi, Stefano; Miele, Erasmo; Arrigo, Serena; Graziani, Maria Giovanna; Cardile, Sabrina; Gaiani, Federica; de’Angelis, Gian Luigi; Torroni, Filippo

    2017-01-01

    There are many causes of gastrointestinal bleeding (GIB) in children, and this condition is not rare, having a reported incidence of 6.4%. Causes vary with age, but show considerable overlap; moreover, while many of the causes in the pediatric population are similar to those in adults, some lesions are unique to children. The diagnostic approach for pediatric GIB includes definition of the etiology, localization of the bleeding site and determination of the severity of bleeding; timely and accurate diagnosis is necessary to reduce morbidity and mortality. To assist medical care providers in the evaluation and management of children with GIB, the “Gastro-Ped Bleed Team” of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP) carried out a systematic search on MEDLINE via PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) to identify all articles published in English from January 1990 to 2016; the following key words were used to conduct the electronic search: “upper GIB” and “pediatric” [all fields]; “lower GIB” and “pediatric” [all fields]; “obscure GIB” and “pediatric” [all fields]; “GIB” and “endoscopy” [all fields]; “GIB” and “therapy” [all fields]. The identified publications included articles describing randomized controlled trials, reviews, case reports, cohort studies, case-control studies and observational studies. References from the pertinent articles were also reviewed. This paper expresses a position statement of SIGENP that can have an immediate impact on clinical practice and for which sufficient evidence is not available in literature. The experts participating in this effort were selected according to their expertise and professional qualifications. PMID:28293079

  10. Colorectal cancer surveillance after index colonoscopy: Guidance from the Canadian Association of Gastroenterology

    PubMed Central

    Leddin, Desmond; Enns, Robert; Hilsden, Robert; Fallone, Carlo A; Rabeneck, Linda; Sadowski, Daniel C; Singh, Harminder

    2013-01-01

    BACKGROUND: Differences between American (United States [US]) and European guidelines for colonoscopy surveillance may create confusion for the practicing clinician. Under- or overutilization of surveillance colonoscopy can impact patient care. METHODS: The Canadian Association of Gastroenterology (CAG) convened a working group (CAG-WG) to review available guidelines and provide unified guidance to Canadian clinicians regarding appropriate follow-up for colorectal cancer (CRC) surveillance after index colonoscopy. A literature search was conducted for relevant data that postdated the published guidelines. RESULTS: The CAG-WG chose the 2012 US Multi-Society Task Force (MSTF) on Colorectal Cancer to serve as the basis for the Canadian position, primarily because the US approach was the simplest and comprehensively addressed the issue of serrated polyps. Aspects of other guidelines were incorporated where relevant. The CAG-WG recommendations differed from the US MSTF guidelines in three main areas: patients with negative index colonoscopy should be followed-up at 10 years using any of the appropriate screening tests, including colonos-copy, for average-risk individuals; among patients with >10 adenomas, a one-year interval for subsequent colonoscopy is recommended; and for long-term follow-up, patients with low-risk adenomas on both the index and first follow-up procedures can undergo second follow-up colonos-copy at an interval of five to 10 years. DISCUSSION: The CAG-WG adapted the US MSTF guidelines for colonoscopy surveillance to the Canadian health care environment with a few modifications. It is anticipated that the present article will provide unified guidance that will enhance physician acceptance and encourage appropriate utilization of recommended surveillance intervals. PMID:23616961

  11. Employment prospects and trends for gastroenterology trainees in Canada: A nationwide survey

    PubMed Central

    Razik, Roshan; Cino, Maria; Nguyen, Geoffrey C

    2013-01-01

    BACKGROUND: Many gastroenterology (GI) trainees face a variety of barriers to stable employment and are finding it increasingly difficult to secure employment in their chosen field. OBJECTIVE: To elucidate factors that contribute to the burden of unemployment and underemployment, and to examine solutions that may remedy this growing problem in the field of GI. METHODS: A nationwide survey of current, incoming and recently graduated individuals of GI training programs in Canada was conducted. Trainees in pediatric GI programs and those enrolled in sub-specialty programs within GI were also included. RESULTS: The response rate was 62%, with 93% of respondents enrolled in an adult GI training program. Many (73%) respondents planned to pursue further subspecialty training and the majority (53%) reported concerns regarding job security after graduation as contributory factors. Only 35% of respondents were confident that they would secure employment within six months of completing their training. Regarding barriers to employment, the most cited perceived reasons were lack of funding (both from hospitals and provincial governments) and senior physicians who continue to practice beyond retirement years. Sixty-nine per cent perceived a greater need for career guidance and 49% believed there were too many GI trainees relative to the current job market in their area. Most residents had a contingency plan if they remained unemployed >18 months, which often included moving to another province or to the United States. CONCLUSION: GI trainees throughout Canada reported substantial concerns about securing employment, citing national retirement trends and lack of funding as primary barriers to employment. Although these issues are not easily modifiable, certain problems should be targeted including optimizing training quotas, tailoring career guidance to the needs of the population, and emphasizing credentialing and quality control in endoscopy. PMID:24199210

  12. Medical Child Abuse (Munchausen Syndrome by Proxy): Multidisciplinary Approach from a Pediatric Gastroenterology Perspective.

    PubMed

    Ali-Panzarella, Andrea Z; Bryant, Tamika J; Marcovitch, Hannah; Lewis, Jeffery D

    2017-04-01

    We highlight the need for a multidisciplinary approach to the diagnosis of medical child abuse, also known as factitious disorder imposed on another (FDIA) or Munchausen syndrome by proxy (MSP), and review our experience focusing on the variety of symptoms that often present to the pediatric gastroenterologist many months before the diagnosis is made. Recent literature on medical child abuse, mostly case reports, is markedly limited, highlighting a need for increased research on this topic. Articles agree on the value of a multidisciplinary approach to these cases and the importance of involving professionals outside the hospital setting. Given the technology-dependent nature of our current society, the use of social media to aid in making the diagnosis has emerged. Review of the literature shows that there are almost no data on long-term outcomes of the victims or perpetrators of MSP. Making the diagnosis of MSP involves a complicated process of piecing together inconsistencies among the history, examination, and clinical presentation. The diagnosis remains difficult and is not often considered during early presentation of symptoms. Once MSP is suspected, it is important that a multidisciplinary process is used, incorporating input from various sources: the outpatient care structure, the hospital, non-hospital agencies such as school and child protective services, and non-traditional sources such as social media. In our experience, a multidisciplinary approach augmented by thoughtful inpatient surveillance provides the greatest opportunity for confirming or excluding MSP. Pediatric gastroenterology is one of the most common services consulted prior to diagnosis and presents an opportunity for early intervention.

  13. Invited Review: The preterm pig as a model in pediatric gastroenterology

    PubMed Central

    Sangild, P. T.; Thymann, T.; Schmidt, M.; Stoll, B.; Burrin, D. G.; Buddington, R. K.

    2014-01-01

    At birth, the newborn mammal undergoes a transition from a sterile uterine environment with a constant nutrient supply, to a microbe-rich environment with intermittent oral intake of complex milk nutrients via the gastrointestinal tract (GIT). These functional challenges partly explain the relatively high morbidity and mortality of neonates. Preterm birth interrupts prenatal organ maturation, including that of the GIT, and increases disease risk. Exemplary is necrotizing enterocolitis (NEC), which is associated closely with GIT immaturity, enteral feeding, and bacterial colonization. Infants with NEC may require resection of the necrotic parts of the intestine, leading to short bowel syndrome (SBS), characterized by reduced digestive capacity, fluid loss, and dependency on parenteral nutrition. This review presents the preterm pig as a translational model in pediatric gastroenterology that has provided new insights into important pediatric diseases such as NEC and SBS. We describe protocols for delivery, care, and handling of preterm pigs, and show how the immature GIT responds to delivery method and different nutritional and therapeutic interventions. The preterm pig may also provide a sensitive model for postnatal adaptation of weak term piglets showing high mortality. Attributes of the preterm pig model include close similarities with preterm infants in body size, organ development, and many clinical features, thereby providing a translational advantage relative to rodent models of GIT immaturity. On the other hand, the need for a sow surgical facility, a piglet intensive care unit, and clinically trained personnel may limit widespread use of preterm pigs. Studies on organ adaptation in preterm pigs help to identify the physiological basis of neonatal survival for hypersensitive newborns and aid in defining the optimal diet and rearing conditions during the critical neonatal period. PMID:23942716

  14. American Gastroenterological Association Institute Technical Review on the Role of Elastography in Chronic Liver Diseases.

    PubMed

    Singh, Siddharth; Muir, Andrew J; Dieterich, Douglas T; Falck-Ytter, Yngve T

    2017-05-01

    Chronic liver diseases (CLDs), due to chronic hepatitis C; hepatitis B; nonalcoholic fatty liver diseases (NAFLD); and alcoholic liver disease, are a leading cause of morbidity and mortality globally. Early identification of patients with cirrhosis at high risk of progression to liver-related complications may facilitate timely care and improve outcomes. With risks and misclassification associated with invasive tests, such as liver biopsy, noninvasive imaging modalities for liver fibrosis assessment have gained popularity. Therefore, the American Gastroenterological Association prioritized clinical guidelines on the role of elastography in CLDs, focusing on vibration-controlled transient elastography (VCTE) and magnetic resonance elastography (MRE). To inform these clinical guidelines, the current technical review was developed in accordance with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework for diagnostic accuracy studies. This technical review addresses focused questions related to: (1) comparative diagnostic performance of VCTE and MRE relative to nonproprietary, serum-based fibrosis markers for detection of cirrhosis in patients with hepatitis C virus (HCV), hepatitis B virus (HBV), NAFLD, and alcoholic liver diseases; (2) performance of specific VCTE-defined liver stiffness cutoffs as a test replacement strategy (to replace liver biopsy) in making key decisions in the management of patients with CLDs; and (3) performance of specific VCTE-defined liver stiffness cutoffs as a triage test to identify patients with low likelihood of harboring high-risk esophageal varices (EVs) or having clinically significant portal hypertension (for presurgical risk stratification). This technical review does not address performance of other noninvasive modalities for assessing fibrosis (eg, acoustic radiation force pulse imaging or shear wave elastography) or steatosis (controlled attenuation parameter or magnetic resonance imaging

  15. Patterns of utilization of complementary and alternative medicine in 2 pediatric gastroenterology clinics.

    PubMed

    Adams, Denise; Schiffgen, Miriam; Kundu, Anjana; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W James; Vohra, Sunita

    2014-09-01

    The aim of the present study was to assess the prevalence and patterns of complementary and alternative medicine (CAM) use among pediatric patients with gastrointestinal (GI) disorders at academic clinics in Canada. The survey was carried out at 2 hospital-based gastroenterology clinics: the Stollery Children's Hospital in Edmonton and the Children's Hospital of Eastern Ontario (CHEO) in Ottawa. CAM use at the Stollery was 83% compared with 36% at CHEO (P < 0.001). The most common reason for not using CAM was lack of knowledge about it. Most respondents felt comfortable discussing CAM in their clinic and wanted more information on CAM. The most common CAM products being taken were multivitamins (91%), calcium (35%), vitamin C (32%), probiotics (14%), and fish oil/omega-3 fatty acids (13%). The most common CAM practices being used were massage (43%), chiropractic (27%), faith healing (25%), and relaxation (18%). Most respondents believed that CAM was helpful, and most of the 23 reported adverse effects were minor. Seven were reported as moderate, and 3 were reported as severe. Many (42%) patients used CAM at the same time as prescription medicines, and of these patients, concurrent use was discussed with their physician (76%) or pharmacist (52%). CAM use is high among pediatric patients with GI disorders and is much greater among those in Edmonton than in Ottawa. Most respondents reported their CAM use as helpful, with little or no associated harm. Many patients fail to disclose their concurrent use of CAM and conventional medicines to their doctors, increasing the likelihood of interactions.

  16. Utilization of and adherence to the gastroenterology core curriculum on hepatology training during a gastrointestinal fellowship.

    PubMed

    Guardino, Jason M; Proctor, Deborah D; Lopez, Rocio; Carey, William

    2008-06-01

    The gastroenterology core curriculum (GCC) represents the knowledge/skills desired at the completion of fellowship training. The hepatology subset (H-GCC) is the focus of this research. The aims were to measure adherence of the H-GCC within gastrointestinal training programs, compare the perceptions of the H-GCC compliance by fellows and program directors, and provide comparative information to improve gastrointestinal training programs. A questionnaire was designed to assess the general and hepatology components of the GCC. Fellows and program directors were invited to participate by means of 3 sequential mailings. Pearson chi(2) and Fisher exact tests were used for statistics. Of 971 potential respondents, the questionnaire was returned by 42% of program directors and 33% of fellows. There was <70% agreement by either fellows or program directors for minimum > or =18 months of clinical training (minimum > or =30% hepatology), and minimum > or =20 paracentesis/liver biopsies. Most prescribed hepatology core topics were covered; however, >10% of fellows claimed deficiency in physiology, pregnancy issues, angiography, immunosuppressant use, and congenital disorders. Fellows in non-liver transplant institutions more often reported lack of training in fulminant disease, transplant patient selection, and diagnosis/management of rejection (P < .001). (1) Fellow and program director assessments were highly concordant, with most H-GCC criteria being met. (2) Attention is required to provide adequate time for clinical training and prescribed procedures. (3) Improved instruction in several hepatology topics seems warranted. (4) A nonevaluative questionnaire is a practical means to measure compliance. Future studies measuring compliance with other components of the GCC by using this methodology seem feasible.

  17. Training directors have positive perceptions of a competency-based gastroenterology and transplant hepatology fellowship program.

    PubMed

    Halegoua-De Marzio, Dina L; Herrine, Steven K

    2015-02-01

    In 2012, the American Board of Internal Medicine approved a pilot competency-based transplant hepatology (TH) training program. This program allows gastroenterology (GI) and TH fellowships to be completed in 3 years. We investigated the perceptions and beliefs of GI and TH division and fellowship program directors on the competency-based TH training program. All current GI and TH division and fellowship program directors from the 162 fellowship programs accredited by the Accreditation Council for Graduate Medical Education were invited via e-mail to anonymously complete the online survey. The survey questioned their perceptions of the 3-year combined GI and TH training program. A total of 116 participants completed the survey (∼38% response rate). Most respondents were GI fellowship directors (61%); 15% were GI and hepatology division directors, 19% were TH fellowship directors, 14% were TH division directors, and 5% were GI division directors. Most of the respondents were in favor of the pilot program (85%). Only 63% of all respondents believed that graduates of the pilot program would achieve the same level of competency in GI as those who completed the traditional program. Overall, 71% believed incorporation of the 3-year training model would increase interest and participation in TH fellowships. Most of the academic GI and TH division and fellowship program directors embrace competency-based fellowship education and TH subspecialty training during the designated 3-year GI fellowship. Future studies will be needed to reevaluate these beliefs after several years. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  18. Prevalence of DSM-5 avoidant/restrictive food intake disorder in a pediatric gastroenterology healthcare network.

    PubMed

    Eddy, Kamryn T; Thomas, Jennifer J; Hastings, Elizabeth; Edkins, Katherine; Lamont, Evan; Nevins, Caitlin M; Patterson, Rebecca M; Murray, Helen B; Bryant-Waugh, Rachel; Becker, Anne E

    2015-07-01

    Few published studies have evaluated the clinical utility of new diagnostic criteria for avoidant/restrictive food intake disorder (ARFID), a DSM-5 reformulation of feeding and eating disorder of infancy or early childhood. We examined the prevalence of ARFID and inter-rater reliability of its diagnostic criteria in a pediatric gastrointestinal sample. We conducted a retrospective chart review of 2,231 consecutive new referrals (ages 8-18 years) to 19 Boston-area pediatric gastroenterology clinics for evidence of DSM-5 ARFID. We identified 33 (1.5%) ARFID cases; 22 of whom (67%) were male. Most were characterized by insufficient intake/little interest in feeding (n = 19) or limited diet due to sensory features of the food (n = 7). An additional 54 cases (2.4%) met one or more ARFID criteria but there was insufficient information in the medical record to confer or exclude the diagnosis. Diagnostic agreement between coders was adequate (κ = 0.72). Common challenges were (i) distinguishing between diagnoses of ARFID and anorexia nervosa or anxiety disorders; (ii) determination of whether the severity of the eating/feeding disturbance was sufficient to warrant diagnosis in the presence of another medical or psychiatric disorder; and (iii) assessment of psychosocial impairment related to eating/feeding problems. In a pediatric treatment-seeking sample where ARFID features were common, cases meeting full criteria were rare, suggesting that the diagnosis is not over-inclusive even in a population where eating/feeding difficulties are expected. © 2014 Wiley Periodicals, Inc.

  19. British Society of Gastroenterology position statement on serrated polyps in the colon and rectum

    PubMed Central

    East, James E; Atkin, Wendy S; Bateman, Adrian C; Clark, Susan K; Dolwani, Sunil; Ket, Shara N; Leedham, Simon J; Phull, Perminder S; Rutter, Matt D; Shepherd, Neil A; Tomlinson, Ian; Rees, Colin J

    2017-01-01

    Serrated polyps have been recognised in the last decade as important premalignant lesions accounting for between 15% and 30% of colorectal cancers. There is therefore a clinical need for guidance on how to manage these lesions; however, the evidence base is limited. A working group was commission by the British Society of Gastroenterology (BSG) Endoscopy section to review the available evidence and develop a position statement to provide clinical guidance until the evidence becomes available to support a formal guideline. The scope of the position statement was wide-ranging and included: evidence that serrated lesions have premalignant potential; detection and resection of serrated lesions; surveillance strategies after detection of serrated lesions; special situations—serrated polyposis syndrome (including surgery) and serrated lesions in colitis; education, audit and benchmarks and research questions. Statements on these issues were proposed where the evidence was deemed sufficient, and re-evaluated modified via a Delphi process until >80% agreement was reached. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool was used to assess the strength of evidence and strength of recommendation for finalised statements. Key recommendation: we suggest that until further evidence on the efficacy or otherwise of surveillance are published, patients with sessile serrated lesions (SSLs) that appear associated with a higher risk of future neoplasia or colorectal cancer (SSLs ≥10 mm or serrated lesions harbouring dysplasia including traditional serrated adenomas) should be offered a one-off colonoscopic surveillance examination at 3 years (weak recommendation, low quality evidence, 90% agreement). PMID:28450390

  20. British Society of Gastroenterology position statement on serrated polyps in the colon and rectum.

    PubMed

    East, James E; Atkin, Wendy S; Bateman, Adrian C; Clark, Susan K; Dolwani, Sunil; Ket, Shara N; Leedham, Simon J; Phull, Perminder S; Rutter, Matt D; Shepherd, Neil A; Tomlinson, Ian; Rees, Colin J

    2017-07-01

    Serrated polyps have been recognised in the last decade as important premalignant lesions accounting for between 15% and 30% of colorectal cancers. There is therefore a clinical need for guidance on how to manage these lesions; however, the evidence base is limited. A working group was commission by the British Society of Gastroenterology (BSG) Endoscopy section to review the available evidence and develop a position statement to provide clinical guidance until the evidence becomes available to support a formal guideline. The scope of the position statement was wide-ranging and included: evidence that serrated lesions have premalignant potential; detection and resection of serrated lesions; surveillance strategies after detection of serrated lesions; special situations-serrated polyposis syndrome (including surgery) and serrated lesions in colitis; education, audit and benchmarks and research questions. Statements on these issues were proposed where the evidence was deemed sufficient, and re-evaluated modified via a Delphi process until >80% agreement was reached. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool was used to assess the strength of evidence and strength of recommendation for finalised statements. Key recommendation: we suggest that until further evidence on the efficacy or otherwise of surveillance are published, patients with sessile serrated lesions (SSLs) that appear associated with a higher risk of future neoplasia or colorectal cancer (SSLs ≥10 mm or serrated lesions harbouring dysplasia including traditional serrated adenomas) should be offered a one-off colonoscopic surveillance examination at 3 years (weak recommendation, low quality evidence, 90% agreement). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Are we meeting the British Society of Gastroenterology guidelines for cholecystectomy post-gallstone pancreatitis?

    PubMed

    Creedon, Lee R; Neophytou, Chris; Leeder, Paul C; Awan, Altaf K

    2016-12-01

    The aim of this study was to audit the current management of patients suffering with gallstone pancreatitis (GSP) at a university teaching hospital for compliance with the British Society of Gastroenterology (BSG) guidelines regarding cholecystectomy post-GSP. Data were collected on all patients identified via the hospital coding department that presented with GSP between January 2011 and November 2013. Patients with alcoholic pancreatitis were excluded. The primary outcome was the length of time in days from diagnosis of GSP to cholecystectomy. Secondary outcomes included readmission with gallstone-related disease prior to definitive management and admitting speciality. One hundred and fifty-eight patients were identified with a presentation of GSP during the study period. Thirty-nine patients were treated conservatively. One hundred and six patients underwent laparoscopic cholecystectomy a median (interquartile range) interval of 33.5 days (64 days) post-admission. Patients with a severe attack as classified by the Glasgow severity score (n = 16) waited a median of 79.5 days (71.5) for cholecystectomy. Only 32% (n = 34) of patients with mild disease underwent cholecystectomy during the index admission or within 2 weeks. When grouped by admitting speciality, patients admitted initially under hepatobiliary surgery waited significantly fewer days for definitive treatment compared with other specialities (P < 0.0001). Twenty-one patients (19.8%) re-presented with gallstone-related pathology prior to undergoing cholecystectomy. Only 32.1% were treated as per BSG guidelines. About 19.8% (n = 21) of the patients suffered further morbidity as a result of a delayed operation and there is a clear difference between admitting speciality and the median time to operation. © 2014 Royal Australasian College of Surgeons.

  2. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease.

    PubMed

    Husby, S; Koletzko, S; Korponay-Szabó, I R; Mearin, M L; Phillips, A; Shamir, R; Troncone, R; Giersiepen, K; Branski, D; Catassi, C; Lelgeman, M; Mäki, M; Ribes-Koninckx, C; Ventura, A; Zimmer, K P

    2012-01-01

    Diagnostic criteria for coeliac disease (CD) from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) were published in 1990. Since then, the autoantigen in CD, tissue transglutaminase, has been identified; the perception of CD has changed from that of a rather uncommon enteropathy to a common multiorgan disease strongly dependent on the haplotypes human leukocyte antigen (HLA)-DQ2 and HLA-DQ8; and CD-specific antibody tests have improved. A panel of 17 experts defined CD and developed new diagnostic criteria based on the Delphi process. Two groups of patients were defined with different diagnostic approaches to diagnose CD: children with symptoms suggestive of CD (group 1) and asymptomatic children at increased risk for CD (group 2). The 2004 National Institutes of Health/Agency for Healthcare Research and Quality report and a systematic literature search on antibody tests for CD in paediatric patients covering the years 2004 to 2009 was the basis for the evidence-based recommendations on CD-specific antibody testing. In group 1, the diagnosis of CD is based on symptoms, positive serology, and histology that is consistent with CD. If immunoglobulin A anti-tissue transglutaminase type 2 antibody titers are high (>10 times the upper limit of normal), then the option is to diagnose CD without duodenal biopsies by applying a strict protocol with further laboratory tests. In group 2, the diagnosis of CD is based on positive serology and histology. HLA-DQ2 and HLA-DQ8 testing is valuable because CD is unlikely if both haplotypes are negative. The aim of the new guidelines was to achieve a high diagnostic accuracy and to reduce the burden for patients and their families. The performance of these guidelines in clinical practice should be evaluated prospectively.

  3. Screening of Inflammatory Bowel Disease and Spondyloarthritis for Referring Patients Between Rheumatology and Gastroenterology.

    PubMed

    Sanz Sanz, Jesús; Juanola Roura, Xavier; Seoane-Mato, Daniel; Montoro, Miguel; Gomollón, Fernando

    2017-08-04

    To define clinical screening criteria for spondyloarthritis (SpA) in patients with inflammatory bowel disease (IBD) and vice versa, which can be used as a reference for referring them to the rheumatology or gastroenterology service. Systematic literature review and a two-round Delphi method. The scientific committee and the expert panel were comprised of 2 rheumatologists and 2 gastroenterologists, and 7 rheumatologists and 7 gastroenterologists, respectively. The scientific committee defined the initial version of the criteria, taking into account sensitivity, specificity, standardization and ease of application. Afterwards, members of the expert panel assessed each item in a two-round Delphi survey. Items that met agreement in the first or second round were included in the final version of the criteria. Positive screening for SpA if at least one of the following is present: onset of chronic low back pain before 45 years of age; inflammatory low back pain or alternating buttock pain; HLA-B27 positivity; sacroiliitis on imaging; arthritis; heel enthesitis; dactylitis. Positive screening for IBD in the presence of one of the major criteria or at least two minor criteria. Major: rectal bleeding; chronic diarrhea with organic characteristics; perianal disease. Minor: chronic abdominal pain; iron deficiency anemia or iron deficiency; extraintestinal manifestations; fever or low grade fever, of unknown origin and duration >1week; unexplained weight loss; family history of IBD. Screening criteria for IBD in patients with SpA, and vice versa, have been developed. These criteria will be useful for early detection of both diseases. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  4. Screening of Inflammatory Bowel Disease and Spondyloarthritis for Referring Patients Between Rheumatology and Gastroenterology.

    PubMed

    Sanz Sanz, Jesús; Juanola Roura, Xavier; Seoane-Mato, Daniel; Montoro, Miguel; Gomollón, Fernando

    2017-09-04

    To define clinical screening criteria for spondyloarthritis (SpA) in patients with inflammatory bowel disease (IBD) and vice versa, which can be used as a reference for referring them to the rheumatology or gastroenterology service. Systematic literature review and a two-round Delphi method. The scientific committee and the expert panel were comprised of 2 rheumatologists and 2 gastroenterologists, and 7 rheumatologists and 7 gastroenterologists, respectively. The scientific committee defined the initial version of the criteria, taking into account sensitivity, specificity, standardization and ease of application. Afterwards, members of the expert panel assessed each item in a two-round Delphi survey. Items that met agreement in the first or second round were included in the final version of the criteria. Positive screening for SpA if at least one of the following is present: onset of chronic low back pain before 45 years of age; inflammatory low back pain or alternating buttock pain; HLA-B27 positivity; sacroiliitis on imaging; arthritis; heel enthesitis; dactylitis. Positive screening for IBD in the presence of one of the major criteria or at least two minor criteria. Major: rectal bleeding; chronic diarrhea with organic characteristics; perianal disease. Minor: chronic abdominal pain; iron deficiency anemia or iron deficiency; extraintestinal manifestations; fever or low grade fever, of unknown origin and duration >1week; unexplained weight loss; family history of IBD. Screening criteria for IBD in patients with SpA, and vice versa, have been developed. These criteria will be useful for early detection of both diseases. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  5. Hepatology and the Canadian gastroenterologist: interest, attitudes and patterns of practice: results of a national survey from the Canadian Association of Gastroenterology.

    PubMed

    Bain, Vincent G; Wong, Winnie W; Greig, Paul D; Yoshida, Eric M

    2003-01-01

    Hepatology has emerged as a subspecialty distinct from gastroenterology. Despite this, there is no formal certification examination or accredited training program, and training remains combined with gastroenterology. To determine attitudes, perceptions and patterns of practice with respect to liver disease among Canadian gastroenterologists. A survey questionnaire was distributed to clinician gastroenterologists who are members of the Canadian Association of Gastroenterology. The responses of subgroups of respondents were compared by univariate and multivariate statistical techniques. Hepatologists constituted 20 of 201 respondents, the rest identifying themselves as gastroenterologists. Among gastroenterologists, liver disease constituted 10% of in- and out-patient practice. Despite this, 85% of gastroenterologists maintain an interest in hepatology, 49% perform liver biopsies, 60% treat hepatitis C, and 54% treat hepatitis B. In all of these areas, university-based gastroenterologists were consistently less likely than community-based gastroenterologists to maintain an interest and practice in hepatology, a finding that remained statistically significant on multivariate analysis. With regard to hepatology training, 90% of hepatologists and 94% of gastroenterologists felt that hepatology training should remain combined with gastroenterology, although 55% of hepatologists felt that current training was adequate compared with 79% of gastroenterologists, who were satisfied with the status quo. Hepatology remains relevant and important to Canadian gastroenterologists, especially those who have community-based practices. Canadian gastroenterologists and hepatologists are not in favour of separating hepatology training from existing gastroenterology training programs, although hepatologists feel that the current level of training is suboptimal.

  6. Comparison of alcohol-dependent patients at a gastroenterological and a psychiatric ward according to the Lesch alcoholism typology: implications for treatment.

    PubMed

    Vyssoki, Benjamin; Steindl-Munda, Petra; Ferenci, Peter; Walter, Henriette; Höfer, Peter; Blüml, Victor; Friedrich, Fabian; Kogoj, Dagmar; Lesch, Otto M

    2010-01-01

    To assess the clinical and biological status of alcohol-dependent patients admitted to a psychiatric or a gastroenterological ward, assessing and comparing dimensions important for prescribing treatment for withdrawal and relapse prevention. Eighty patients, alcohol-dependent according to international classification of diseases tenth revision and diagnostic and statistical manual, text revised, version IV, admitted to the Vienna General Hospital between January 2005 and  November 2006, were examined, of whom 44 were admitted to the psychiatric ward and 36 to the gastroenterological ward. Dimensions of alcohol dependence were assessed using a computerized structured interview, the Lesch alcoholism typology (LAT). Biological markers and the model for end-stage liver disease (MELD) score defined the severity of alcohol-related physical disturbances. As might be expected, gastroenterological patients had more advanced physical diseases than psychiatric patients, and affective disorders and suicidal tendencies were significantly commoner among the psychiatric patients. Thus, LAT Type II patients were overrepresented at the gastroenterological ward and LAT Type III patients at the psychiatric ward. The severity of somatic diseases and psychiatric disorders as well as the distribution of the four types according to Lesch differ between alcohol-dependent patients admitted to a psychiatric ward or a gastroenterological ward. Regarding the positive long-term outcome, different evidence-based medical treatment approaches for withdrawal and relapse prevention are needed for these patients.

  7. Non-English speakers attend gastroenterology clinic appointments at higher rates than English speakers in a vulnerable patient population.

    PubMed

    Sewell, Justin L; Kushel, Margot B; Inadomi, John M; Yee, Hal F

    2009-08-01

    We sought to identify factors associated with gastroenterology clinic attendance in an urban safety net healthcare system. Missed clinic appointments reduce the efficiency and availability of healthcare, but subspecialty clinic attendance among patients with established healthcare access has not been studied. We performed an observational study using secondary data from administrative sources to study patients referred to, and scheduled for an appointment in, the adult gastroenterology clinic serving the safety net healthcare system of San Francisco, CA. Our dependent variable was whether subjects attended or missed a scheduled appointment. Analysis included multivariable logistic regression and classification tree analysis. A total of 1833 patients were referred and scheduled for an appointment between May 2005 and August 2006. Prisoners were excluded. All patients had a primary care provider. Six hundred eighty-three patients (37.3%) missed their appointment; 1150 patients (62.7%) attended. Language was highly associated with attendance in the logistic regression; non-English speakers were less likely than English speakers to miss an appointment [adjusted odds ratio 0.42 (0.28, 0.63) for Spanish, 0.56 (0.38, 0.82) for Asian language, P<0.001]. Other factors were also associated with attendance, but classification tree analysis identified language to be the most highly associated variable. In an urban safety net healthcare population, among patients with established healthcare access and a scheduled gastroenterology clinic appointment, not speaking English was most strongly associated with higher attendance rates. Patient-related factors associated with not speaking English likely influence subspecialty clinic attendance rates, and these factors may differ from those affecting general healthcare access.

  8. Non-English speakers attend gastroenterology clinic appointments at higher rates than English speakers in a vulnerable patient population

    PubMed Central

    Sewell, Justin L.; Kushel, Margot B.; Inadomi, John M.; Yee, Hal F.

    2009-01-01

    Goals We sought to identify factors associated with gastroenterology clinic attendance in an urban safety net healthcare system. Background Missed clinic appointments reduce the efficiency and availability of healthcare, but subspecialty clinic attendance among patients with established healthcare access has not been studied. Study We performed an observational study using secondary data from administrative sources to study patients referred to, and scheduled for an appointment in, the adult gastroenterology clinic serving the safety net healthcare system of San Francisco, California. Our dependent variable was whether subjects attended or missed a scheduled appointment. Analysis included multivariable logistic regression and classification tree analysis. 1,833 patients were referred and scheduled for an appointment between 05/2005 and 08/2006. Prisoners were excluded. All patients had a primary care provider. Results 683 patients (37.3%) missed their appointment; 1,150 (62.7%) attended. Language was highly associated with attendance in the logistic regression; non-English speakers were less likely than English speakers to miss an appointment (adjusted odds ratio 0.42 [0.28,0.63] for Spanish, 0.56 [0.38,0.82] for Asian language, p < 0.001). Other factors were also associated with attendance, but classification tree analysis identified language to be the most highly associated variable. Conclusions In an urban safety net healthcare population, among patients with established healthcare access and a scheduled gastroenterology clinic appointment, not speaking English was most strongly associated with higher attendance rates. Patient related factors associated with not speaking English likely influence subspecialty clinic attendance rates, and these factors may differ from those affecting general healthcare access. PMID:19169147

  9. Cost-effectiveness analysis of 3-D computerized tomography colonography versus optical colonoscopy for imaging symptomatic gastroenterology patients.

    PubMed

    Gomes, Manuel; Aldridge, Robert W; Wylie, Peter; Bell, James; Epstein, Owen

    2013-04-01

    When symptomatic gastroenterology patients have an indication for colonic imaging, clinicians have a choice between optical colonoscopy (OC) and computerized tomography colonography with three-dimensional reconstruction (3-D CTC). 3-D CTC provides a minimally invasive and rapid evaluation of the entire colon, and it can be an efficient modality for diagnosing symptoms. It allows for a more targeted use of OC, which is associated with a higher risk of major adverse events and higher procedural costs. A case can be made for 3-D CTC as a primary test for colonic imaging followed if necessary by targeted therapeutic OC; however, the relative long-term costs and benefits of introducing 3-D CTC as a first-line investigation are unknown. The aim of this study was to assess the cost effectiveness of 3-D CTC versus OC for colonic imaging of symptomatic gastroenterology patients in the UK NHS. We used a Markov model to follow a cohort of 100,000 symptomatic gastroenterology patients, aged 50 years or older, and estimate the expected lifetime outcomes, life years (LYs) and quality-adjusted life years (QALYs), and costs (£, 2010-2011) associated with 3-D CTC and OC. Sensitivity analyses were performed to assess the robustness of the base-case cost-effectiveness results to variation in input parameters and methodological assumptions. 3D-CTC provided a similar number of LYs (7.737 vs 7.739) and QALYs (7.013 vs 7.018) per individual compared with OC, and it was associated with substantially lower mean costs per patient (£467 vs £583), leading to a positive incremental net benefit. After accounting for the overall uncertainty, the probability of 3-D CTC being cost effective was around 60 %, at typical willingness-to-pay values of £20,000-£30,000 per QALY gained. 3-D CTC is a cost-saving and cost-effective option for colonic imaging of symptomatic gastroenterology patients compared with OC.

  10. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN).

    PubMed

    Vandenplas, Yvan; Rudolph, Colin D; Di Lorenzo, Carlo; Hassall, Eric; Liptak, Gregory; Mazur, Lynnette; Sondheimer, Judith; Staiano, Annamaria; Thomson, Michael; Veereman-Wauters, Gigi; Wenzl, Tobias G; North American Society for Pediatric Gastroenterology Hepatology and Nutrition; European Society for Pediatric Gastroenterology Hepatology and Nutrition

    2009-10-01

    To develop a North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) international consensus on the diagnosis and management of gastroesophageal reflux and gastroesophageal reflux disease in the pediatric population. An international panel of 9 pediatric gastroenterologists and 2 epidemiologists were selected by both societies, which developed these guidelines based on the Delphi principle. Statements were based on systematic literature searches using the best-available evidence from PubMed, Cumulative Index to Nursing and Allied Health Literature, and bibliographies. The committee convened in face-to-face meetings 3 times. Consensus was achieved for all recommendations through nominal group technique, a structured, quantitative method. Articles were evaluated using the Oxford Centre for Evidence-based Medicine Levels of Evidence. Using the Oxford Grades of Recommendation, the quality of evidence of each of the recommendations made by the committee was determined and is summarized in appendices. More than 600 articles were reviewed for this work. The document provides evidence-based guidelines for the diagnosis and management of gastroesophageal reflux and gastroesophageal reflux disease in the pediatric population. This document is intended to be used in daily practice for the development of future clinical practice guidelines and as a basis for clinical trials.

  11. AAPCC Annual Reports

    MedlinePlus

    ... Annual Report 2000 Annual Report 1999 Annual Report Poison Data National Poison Data System Uses for NPDS ... Elements NPDS FAQs Annual Reports Find Your Local Poison Center Poison centers offer free, private, confidential medical ...

  12. Effects of Starting a Gastroenterology Fellowship Training Program on Quality Measures of Colonoscopy.

    PubMed

    Elhanafi, Sherif; Chhana, Rahul; Mallawaarachchi, Indika; Lou, Wynee; Rangel, Gabriela; Fang, Hongfei; Patel, Rinkal; Dwivedi, Alok Kumar; Zuckerman, Marc J; Othman, Mohamed O

    2017-03-01

    Adenoma detection rate (ADR) is the most established indicator of the quality of screening colonoscopy. The effect of gastroenterology (GI) fellows on the quality of screening colonoscopies has been evaluated previously; however, the effect of starting a new GI fellowship program on the quality of screening colonoscopies has not been studied. The aim of our study was to assess the effects of starting a GI fellowship program and the participation of fellows in screening colonoscopies on ADR and other measures of quality. This was a retrospective, cross-sectional study of all screening colonoscopies performed 20 months before and 20 months after starting the GI fellowship at our medical center (November 2010-February 2014). Colonoscopy procedure notes and pathology records were reviewed for each patient. Data from the two periods were compared using either the Fisher exact test or the two-sample t test. A total of 2127 complete colonoscopies were included in the analysis. The mean age of patients was 58.8 ± 6.6 years. Of the 2127 colonoscopies, GI fellows were involved in 385 (18%), whereas 1742 (82%) were performed solely by GI attendings (attending physicians). Multivariate analysis using relative risk (RR) of regression was done. The after starting the GI fellowship period was significantly associated with an increase in ADR (RR 1.19, 95% confidence interval 1.10-1.30, P < 0.001) and advanced adenoma detection rate (RR 1.17, 95% confidence interval 1.00-1.38, P < 0.001) compared with the before starting the GI fellowship period. In the after starting the GI fellowship period, the polyp detection rate and ADR for colonoscopies performed by the attending physicians with the fellows were significantly higher than colonoscopies performed solely by the same attendings (58.4% vs 44.5%, P = 0.001, 42.0% vs 32.9%, P = 0.017, respectively). Starting a GI fellowship program significantly increased the polyp detection rate, ADR, and advanced ADR.

  13. Influence of Peri-Operative Hypothermia on Surgical Site Infection in Prolonged Gastroenterological Surgery.

    PubMed

    Tsuchida, Toshie; Takesue, Yoshio; Ichiki, Kaoru; Uede, Takashi; Nakajima, Kazuhiko; Ikeuchi, Hiroki; Uchino, Motoi

    2016-10-01

    There have been several recent studies on the correlation between intra-operative hypothermia and the occurrence of surgical site infection (SSI). Differences in the depth and timing of hypothermia and the surgical procedure may have led to conflicting results. Patients undergoing gastroenterologic surgery with a duration of >3 h were analyzed. Hypothermia was defined as a core temperature <36°C and was classified as mild (35.5-35.9°C), moderate (35.0-35.4°C), or severe (<35.0°C). Hypothermia also was classified as early-nadir (<36°C within two h of anesthesia induction) and late-nadir (after that time). Risk factors for SSIs were analyzed according to these classifications. Among 1,409 patients, 528 (37.5%) had hypothermia, which was classified as mild in 358, moderate in 137, and severe in 33. Early-nadir and late-nadir hypothermia was found in 23.7% and 13.8%, respectively. There was no significant difference in the incidence of SSIs between patients with and without hypothermia (relative risk 1.00; 95% confidence interval [CI] 0.80-1.25; p = 0.997). However, there was a significantly greater incidence of SSIs in patients with severe hypothermia (33.3%) than in those with normothermia (19.2%; p = 0.045) or mild hypothermia (17.0%; p = 0.021). The incidence of SSIs also was significantly greater in patients with late-nadir than in those with early-nadir hypothermia (23.7% vs. 16.5%; p = 0.041). The incidence of organ/space SSIs was significantly greater in patients with late-nadir hypothermia (19.6%) than in patients with normothermia (12.7%; p = 0.012). In multivariable analysis, neither severe hypothermia (odds ratio 1.24; 95% CI 0.56-2.77] nor late-nadir hypothermia (OR 0.71; 95% CI 0.46-1.01) was an independent risk factor for SSIs. Severe and late-nadir hypothermia were associated with a greater incidence of SSIs and organ/space SSIs. However, neither of these patterns was identified as an independent risk factor for SSIs, possibly

  14. Endoscopy nurse as a patient care coordinator: the expanded role of the competent nurse in the gastroenterology setting.

    PubMed

    Vuorinen, Riitta; Heino, Eila; Meretoja, Riitta

    2009-01-01

    Several methods are used to describe and evaluate competence profiles of registered nurses. A clinical ladder program based on P. Benner's (1984; P. Benner et al., 1996) competency framework has been used for 20 years in a Finnish university hospital; to ensure the nurses' strategic competencies and capability profiles, the Nurse Competence Scale (NCS) was developed for the self-assessment and the superiors' review purposes (R. Meretoja, H. Isoaho, & H. Leino-Kilpi, 2004; R. Meretoja, H. Leino-Kilpi, & A. M. Kaira, 2004). In the gastroenterological endoscopy unit, competent nurses' work role has been expanded to the proficient level. These nurses are working as patient care coordinators in multiprofessional groups. This expanded work role requires mastery of nursing care for the gastroenterological patients and also familiarity of the endoscopy processes and the clinical pathways. These endoscopy nurse coordinators' most important work role is the effective management of situations, and they are also remarkable resources as preceptors and mentors to less experienced nurses and nursing students. This article describes endoscopy nurse coordinators' expanded work role and competence profile in the frame of the clinical ladder program.

  15. Measuring the intuitive response of users when faced with different interactive paradigms to control a gastroenterology CAD system.

    PubMed

    Abrantes, D; Gomes, P; Pereira, D; Coimbra, M

    2016-08-01

    The gastroenterology specialty could benefit from the introduction of Computer Assisted Decision (CAD) systems, since gastric cancer is a serious concern in which an accurate and early diagnosis usually leads to a good prognosis. Still, the way doctors interact with these systems is very important because it will often determine its embracement or rejection, as any gains in productivity will frequently hinge on how comfortable they are with it. Using other types of interaction paradigms such as voice and motion control, is important in a way that typical inputs such as keyboard and mouse are sometimes not the best choice for certain clinical scenarios. In order to ascertain how a doctor could control a hypothetical CAD system during a gastroenterology exam, we measured the natural response of users when faced with three different task requests, using three types of interaction paradigms: voice, gesture and endoscope. Results fit in what was expected, with gesture control being the most intuitive to use, and the endoscope being on the other edge. All the technologies are mature enough to cope with the response concepts the participants gave us. However, when having into account the scenario context, better natural response scores may not always be the best choice for implementation. That way, simplification or reduction of tasks, along with a well tought-out interface, or even mixing more oriented paradigms for particular requests, could allow for better system control with fewer inconveniences for the user.

  16. Self-management for patients with inflammatory bowel disease in a gastroenterology ward in China: a best practice implementation project.

    PubMed

    Chen, Ruo-Bing

    2016-11-01

    Globally, there is an increasing incidence of inflammatory bowel disease. It is very important for patients to be involved with self-management that can optimize personal heath behavior to control the disease. The aim of this project was to increase nursing staff knowledge of inflammatory bowel disease discharge guidance, and to improve the quality of education for discharged patients, thereby improving their self-management. A baseline audit was conducted by interviewing 30 patients in the gastroenterology ward of Huadong Hospital, Fudan University. The project utilized the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research Into Practice audit tools for promoting quality of education and self-management of patients with inflammatory bowel disease. Thirty patients were provided with written materials, which included disease education and information regarding self-management. A post-implementation audit was conducted. There was improvement of education prior to discharge and dietary consultancy in the gastroenterology ward. Self-management plans utilizing written materials only were not sufficient for ensuring sustainability of the project. Comprehensive self-management education can make a contribution to improving awareness of the importance of self-management for patients with inflammatory bowel disease.

  17. Aflatoxins as a risk factor for hepatocellular carcinoma in Egypt, Mansoura Gastroenterology Center study.

    PubMed

    Abdel-Wahab, M; Mostafa, M; Sabry, M; el-Farrash, M; Yousef, Tamer

    2008-01-01

    Aflatoxin B1 (AFB1) is an important food-borne mycotoxin. The co-contamination of foodstuffs with this mycotoxin is well known and has been possibly implicated in the development of hepatocellular carcinoma in high risk regions around the world. This study investigates the serum aflatoxin B1 in patients with hepatocellular carcinoma and compares it to a control group. From January 2005 to January 2006, 80 cases with hepatocellular carcinoma diagnosed in the Gastroenterology center, Mansoura University, Egypt and 20 healthy subjects used as a control group were enrolled in the study. All patients were evaluated for age, sex, residence, occupation, history of other medical diseases, anti-bilharzial treatment, blood transfusion, viral markers, liver functions and serum level of aflatoxin B1. The mean age of our patients was 52.88 +/- 7.27 years versus 53.17 +/- 6.78 years for the controls, p>0.05. The serum level of AFP1 was highly significant in HCC patients compared with control (32.47 +/- 92.46 versus 7.33 +/- 5.5 P<0.0001) and it was statistically high between 51:60-years-old (P<0.05). Males represented 82.5% of the patients versus 17.5% for females. AFB1 was higher in males compared with females (P<0.05), higher in rural residents compared with urban residents (P<0.05), higher in Kafer Elchek government are versus others (P<0.01) and higher in farmers compared with those with other occupations (P<0.05). The serum level of AFB1 was high among patients with a history of anti-bilharzial treatment with tarar emetic versus oral treatment by Brazequantil (P<0.05). Hepatitis C antibody was positive in 70% of the patients. The serum level of AFB1 was statistically high in HCV-positive patients compared with HCV-negative ones (P<0.05) but showed no statistical significance in HBs-positive patients compared with HBs-negative ones (P>0.05). The serum level of AFB1 was statistically high in Child class B patients compared with class A (P<0.05), high in patients with tumor

  18. [Anaemia and iron deficiency in clinical practice:from cardiology to gastroenterology and beyond].

    PubMed

    Češka, Richard

    2014-12-01

    Anaemia is one of the most common diseases. Worldwide affects up to 25% of the population. Anaemia with iron deficiency (Fe) is the leading one. It is not surprising that iron deficiency mainly affects women. Generally, anaemia is one of the major problems in every department of internal medicine. There is no ambition to provide a comprehensive review of the diagnosis and treatment of anaemia. The aim is to point out the common (but sometimes neglected) facts from daily practice in internal department and on the other hand, to highlight the news in the treatment focusing on parenteral Fe.The importance of anaemia at the department of internal medicine. Mentioned above, anaemia is very frequent in internal medicine. Especially, it is anaemia of Fe deficiency and anaemia of chronic disease. Mostly elderly and polymorbid patients (often with one dominant, sometimes cryptogenic disease) suffer from anaemia. I am concern about the fact that anaemia is often seen only as a sign of other disease and usually is not the target of diagnostic and therapeutic efforts.Diagnosis and treatment. The internal department physician is responsible for patient care, but cooperates with haematologist in case of severe anaemia in diagnostic and therapeutic process. Basic examination contains analysis of Fe, ferritin, transferrin, circulating serum transferrin receptors or other parameters. Of course, the focus in iron deficiency anaemia is on its possible loss or in case of chronic disease anaemia on primary disease.Notes to Fe treatment. If the patient has iron deficiency the Fe treatment is often indicated (after finding the cause). Iron is administered orally in most cases. There are several situations when parenteral Fe is not only preferable, but also represents the only therapeutic option. Currently, the best evidence for the positive effects is observed in parenterally administered Fe ferric carboxymaltose, Ferinject.Parenteral administration of Fe in gastroenterology

  19. [Cost assessment for endoscopic procedures in the German diagnosis-related-group (DRG) system - 5 year cost data analysis of the German Society of Gastroenterology project].

    PubMed

    Rathmayer, Markus; Heinlein, Wolfgang; Reiß, Claudia; Albert, Jörg G; Akoglu, Bora; Braun, Martin; Brechmann, Thorsten; Gölder, Stefan K; Lankisch, Tim; Messmann, Helmut; Schneider, Arne; Wagner, Martin; Dollhopf, Markus; Gundling, Felix; Röhling, Michael; Haag, Cornelie; Dohle, Ines; Werner, Sven; Lammert, Frank; Fleßa, Steffen; Wilke, Michael H; Schepp, Wolfgang; Lerch, Markus M

    2017-09-08

    Background In the German hospital reimbursement system (G-DRG) endoscopic procedures are listed in cost center 8. For reimbursement between hospital departments and external providers outdated or incomplete catalogues (e. g. DKG-NT, GOÄ) have remained in use. We have assessed the cost for endoscopic procedures in the G-DRG-system. Methods To assess the cost of endoscopic procedures 74 hospitals, annual providers of cost-data to the Institute for the Hospital Remuneration System (InEK) made their data (2011 - 2015; § 21 KHEntgG) available to the German-Society-of-Gastroenterology (DGVS) in anonymized form (4873 809 case-data-sets). Using cases with exactly one endoscopic procedure (n = 274 186) average costs over 5 years were calculated for 46 endoscopic procedure-tiers. Results Robust mean endoscopy costs ranged from 230.56 € for gastroscopy (144 666 cases), 276.23 € (n = 32 294) for a simple colonoscopy, to 844.07 € (n = 10 150) for ERCP with papillotomy and plastic stent insertion and 1602.37 € (n = 967) for ERCP with a self-expanding metal stent. Higher costs, specifically for complex procedures, were identified for University Hospitals. Discussion For the first time this catalogue for endoscopic procedure-tiers, based on § 21 KHEntgG data-sets from 74 InEK-calculating hospitals, permits a realistic assessment of endoscopy costs in German hospitals. The higher costs in university hospitals are likely due to referral bias for complex cases and emergency interventions. For 46 endoscopic procedure-tiers an objective cost-allocation within the G-DRG system is now possible. By international comparison the costs of endoscopic procedures in Germany are low, due to either greater efficiency, lower personnel allocation or incomplete documentation of the real expenses. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Implementation of baby boomer hepatitis C screening and linking to care in gastroenterology practices: a multi-center pilot study.

    PubMed

    Younossi, Zobair M; LaLuna, Louis L; Santoro, John J; Mendes, Flavia; Araya, Victor; Ravendhran, Natarajan; Pedicone, Lisa; Lio, Idania; Nader, Fatema; Hunt, Sharon; Racila, Andrei; Stepanova, Maria

    2016-04-04

    Estimates suggest that only 20 % of HCV-infected patients have been identified and <10 % treated. However, baby boomers (1945-1965) are identified as having a higher prevalence of HCV which has led the Centers for Disease Control and Prevention to make screening recommendations. The aim of this study was to implement the CDC's screening recommendations in the unique setting of gastroenterology practices in patients previously unscreened for HCV. After obtaining patient informed consent, demographics, clinical and health-related quality of life (HRQOL) data were collected. A blood sample was screened for HCV antibody (HCV AB) using the OraQuick HCV Rapid Antibody Test. HCV AB-positive patients were tested for presence of HCV RNA and, if HCV RNA positive, patients underwent treatment discussions. We screened 2,000 individuals in 5 gastroenterology centers located close to large metropolitan areas on the East Coast (3 Northeast, 1 Mid-Atlantic and 1 Southeast). Of the screened population, 10 individuals (0.5 %) were HCV AB-positive. HCV RNA testing was performed in 90 % (9/10) of HCV AB-positive individuals. Of those, 44.4 % (4/9) were HCV RNA-positive, and all 4 (100 %) were linked to caregiver. Compared to HCV AB negative subjects, HCV AB-positive individuals tended to be black (20.0 vs. 5.2 %, p = 0.09) and reported significantly higher rates of depression: 60.0 vs. 21.5 %, p = 0.009. These individuals also reported a significantly lower HRQOL citing having more fatigue, poorer concentration, and a decreased level of energy (p < 0.05). Although the prevalence of HCV AB-positive was low in previously unscreened subjects screened in the gastroenterology centers, the linkage to care was very high. The sample of patients used in this study may be biased, so further studies are needed to assess the effectiveness of the CDC screening recommendations. Implementation of the Baby Boomer Screening for HCV requires identifying screening environement with high prevalence of

  1. Evaluation of gastroenterology and hepatology articles on Wikipedia: are they suitable as learning resources for medical students?

    PubMed

    Azer, Samy A

    2014-02-01

    With the changes introduced to medical curricula, medical students use learning resources on the Internet such as Wikipedia. However, the credibility of the medical content of Wikipedia has been questioned and there is no evidence to respond to these concerns. The aim of this paper was to critically evaluate the accuracy and reliability of the gastroenterology and hepatology information that medical students retrieve from Wikipedia. The Wikipedia website was searched for articles on gastroenterology and hepatology on 28 May 2013. Copies of these articles were evaluated by three assessors independently using an appraisal form modified from the DISCERN instrument. The articles were scored for accuracy of content, readability, frequency of updating, and quality of references. A total of 39 articles were evaluated. Although the articles appeared to be well cited and reviewed regularly, several problems were identified with regard to depth of discussion of mechanisms and pathogenesis of diseases, as well as poor elaboration on different investigations. Analysis of the content showed a score ranging from 15.6±0.6 to 43.6±3.2 (mean±SD). The total number of references in all articles was 1233, and the number of references varied from 4 to 144 (mean±SD, 31.6±27.3). The number of citations from peer-reviewed journals published in the last 5 years was 242 (28%); however, several problems were identified in the list of references and citations made. The readability of articles was in the range of -8.0±55.7 to 44.4±1.4; for all articles the readability was 26±9.0 (mean±SD). The concordance between the assessors on applying the criteria had mean κ scores in the range of 0.61 to 0.79. Wikipedia is not a reliable source of information for medical students searching for gastroenterology and hepatology articles. Several limitations, deficiencies, and scientific errors have been identified in the articles examined.

  2. Inflammatory bowel disease nurses in Canada: An examination of Canadian gastroenterology nurses and their role in inflammatory bowel disease care

    PubMed Central

    Stretton, Jennifer G; Currie, Barbara K; Chauhan, Usha K

    2014-01-01

    BACKGROUND/OBJECTIVE: Inflammatory bowel disease (IBD) is a chronic relapsing illness primarily including Crohn disease and ulcerative colitis. The disease course often fluctuates over time, and requires maintenance therapy and acute interventions to target disease flares. IBD management requires a multidisciplinary approach, with care from physicians, nurses, dieticians, social workers and psychologists. Because nurses play a pivotal role in managing chronic disease, the aim of the present study was to assess and determine how many nurses work primarily with IBD patients in Canada. METHODS: A 29-question survey was developed using an Internet-based survey tool (www.surveymonkey.com) to investigate nursing demographics, IBD nursing roles and nursing services provided across Canada. Distribution included the Canadian Society of Gastroenterology Nurses and Associates, the Canadian Association of Gastroenterology, Progress (AbbVie Corporation, USA) and BioAdvance (Janssen Inc, USA) coordinators (via e-mail), and online availability for 15 weeks. RESULTS: Of 275 survey respondents, 98.2% were female nurses, with 68.7% employed in full-time positions. Among them, 42.5% were between 51 and 60 years of age, and 32.4% were between 41 and 50 years of age. In addition, 53.8% were diploma-prepared registered nurses, 35.3% were Baccalaureate-prepared nurses and 4.4% were Masters-prepared nurses. Almost one-half (44% [n=121]) were employed in Ontario, followed by 19.6% (n=54) in Alberta and 9.1% (n=25) in British Columbia. All provinces were represented with the exception of Nunavut and the Northwest Territories. Forty-three per cent (n=119) of nurses identified as working in endoscopy units. Of the 90% who responded as working with IBD patients, only 30% (n=79) had a primary role in IBD care. Among these 79 nurses with a primary role in IBD care, 79.7% worked with the adult population, 10.1% with the pediatric population, and 10.1% worked with both adult and pediatric patients

  3. Issues associated with the emergence of coeliac disease in the Asia–Pacific region: a working party report of the World Gastroenterology Organization and the Asian Pacific Association of Gastroenterology.

    PubMed

    Makharia, Govind K; Mulder, Chris J J; Goh, Khean Lee; Ahuja, Vineet; Bai, Julio C; Catassi, Carlo; Green, Peter H R; Gupta, Siddhartha Datta; Lundin, Knut E A; Ramakrishna, Balakrishnan Siddartha; Rawat, Ramakant; Sharma, Hanish; Sood, Ajit; Watanabe, Chikako; Gibson, Peter R

    2014-04-01

    Once thought to be uncommon in Asia, coeliac disease (CD) is now being increasingly recognized in Asia–Pacific region. In many Asian nations, CD is still considered to be either nonexistent or very rare. In recognition of such heterogeneity of knowledge and awareness, the World Gastroenterology Organization and the Asian Pacific Association of Gastroenterology commissioned a working party to address the key issues in emergence of CD in Asia. A working group consisting of members from Asia–Pacific region, Europe, North America, and South America reviewed relevant existing literature with focus on those issues specific to Asia–Pacific region both in terms of what exists and what needs to be done. The working group identified the gaps in epidemiology, diagnosis, and management of CD in Asian–Pacific region and recommended the following: to establish prevalence of CD across region, increase in awareness about CD among physicians and patients, and recognition of atypical manifestations of CD. The challenges such as variability in performance of serological tests, lack of population-specific cut-offs values for a positive test, need for expert dietitians for proper counseling and supervision of patients, need for gluten-free infrastructure in food supply and creation of patient advocacy organizations were also emphasized. Although absolute number of patients with CD at present is not very large, this number is expected to increase over the next few years or decades. It is thus appropriate that medical community across the Asia–Pacific region define extent of problem and get prepared to handle impending epidemic of CD.

  4. [Analysis of factors related to length of stay in the hospital in a hepato-gastroenterology unit].

    PubMed

    Poynard, T; Poitrine, A; Naveau, S; Gaudineau, M D; Trébuchet, L; Chaput, J C

    1983-12-01

    Because hospital length of stay is the most important determinant of cost of hospitalization, this study was performed to analyse factors contributing to hospital length of stay in an hepato-gastroenterology unit. Prospectively collected computerized files of the first 750 patients admitted in 1982 were analyzed according to primary diagnosis, age and sex. Ten primary diagnosis categories were established. By multivariate analysis, alcoholic liver disease and the non-digestive diseases correlated best with the hospital length of stay. Variables most predictive of an hospital length of stay greater than 14 days were diagnosis of alcoholic liver disease, patient age and diagnosis of non-alcoholic cirrhosis. Analyses of this kind are essential in making policy decisions regarding hospital cost reduction.

  5. Diagnosis and treatment of gastroesophageal reflux disease: recommendations of the Asociación Mexicana de Gastroenterología.

    PubMed

    Huerta-Iga, F; Bielsa-Fernández, M V; Remes-Troche, J M; Valdovinos-Díaz, M A; Tamayo-de la Cuesta, J L

    Emerging concepts in the pathophysiology of gastroesophageal reflux disease (GERD) and the constant technologic advances in the diagnosis and treatment of this clinical condition make it necessary to frequently review and update the clinical guidelines, recommendations, and official statements from the leading academic groups worldwide. The Asociación Mexicana de Gastroenterología (AMG), aware of this responsibility, brought together national experts in this field to analyze the most recent scientific evidence and formulate a series of practical recommendations to guide and facilitate the diagnostic process and efficacious treatment of these patients. The document includes algorithms, figures, and tables for convenient consultation, along with opinions on GERD management in sensitive populations, such as pregnant women and older adults.

  6. Spectrum of digestive tract diseases 1985-1987 at the Pediatric Gastroenterology Outpatient Clinic of Dr. Pirngadi General Hospital, Medan.

    PubMed

    Siregar, C D; Sinuhaji, A B; Sutanto, A H

    1990-01-01

    A retrospective study has been done on infants and children attending to the Pediatric Gastroenterology Outpatient Clinic of Dr. Pirngadi General Hospital in Medan, from 1985 through 1987. During the study there were 874 patients, 477 (54.58%) suffered from diarrhea, 209 (23.91%) had bloody stool, 20 (2.99%) jaundice, 57 (6.52%) abdominal pain, 48 (5.49%) abdominal distention, 30 (3.43%) vomiting, 13 (1.49%) constipation, and 20 (2.29%) others. Of all cases with diarrhoea, watery diarrhoea were found in only 319 (66.88%), diarrhoea with vomiting 84 (17.61%), and bloody diarrhoea 74 (15.51%). Stool examination in patients with diarrhoea revealed 144 (30.19%) cases with Candida albicans, while 16 (3.35%) of them with steatorrhoea. Of 63 patients with diarrhoea on which the clinitest had been performed, sugar intolerance were found in 30 (47.62%) cases.

  7. Canadian Association of Gastroenterology position statement on screening individuals at average risk for developing colorectal cancer: 2010.

    PubMed

    Leddin, Desmond J; Enns, Robert; Hilsden, Robert; Plourde, Victor; Rabeneck, Linda; Sadowski, Daniel C; Signh, Harminder

    2010-12-01

    The Canadian Association of Gastroenterology and the Canadian Digestive Health Foundation published guidelines on colon cancer screening in 2004. Subsequent to the publication of these guidelines, many advances have occurred, thereby necessitating a review of the existing guidelines in the context of new technologies and clinical knowledge. The assembled guideline panel recognized three recent American sets of guidelines and identified seven issues that required comment from a Canadian perspective. These issues included, among others, the role of program-based screening, flexible sigmoidoscopy, computed tomography colonography, barium enema and quality improvement. The panel also provided context for the selection of the fecal immunochemical test as the fecal occult blood test of choice, and the relative role of colonoscopy as a primary screening tool. Recommendations were also provided for an upper age limit for colon cancer screening, whether upper endoscopy should be performed following a negative colonoscopy for a positive fecal occult blood test and when colon cancer screening should resume following negative colonoscopy.

  8. Remote transmission of live endoscopy over the Internet: Report from the 87th Congress of the Japan Gastroenterological Endoscopy Society.

    PubMed

    Shimizu, Shuji; Ohtsuka, Takao; Takahata, Shunichi; Nagai, Eishi; Nakashima, Naoki; Tanaka, Masao

    2016-01-01

    Live demonstration of endoscopy is one of the most attractive and useful methods for education and is often organized locally in hospitals. However, problems have been apparent in terms of cost, preparation, and potential risks to patients. Our aim was to evaluate a new approach to live endoscopy whereby remote hospitals are connected by the Internet for live endoscopic demonstrations. Live endoscopy was transmitted to the Congress of the Japan Gastroenterological Endoscopic Society by 13 domestic and international hospitals. Patients with upper and lower gastrointestinal diseases and with pancreatobiliary disorders were the subjects of a live demonstration. Questionnaires were distributed to the audience and were sent to the demonstrators. Questions concerned the quality of transmitted images and sound, cost, preparations, programs, preference of style, and adverse events. Of the audience, 91.2% (249/273) answered favorably regarding the transmitted image quality and 93.8% (259/276) regarding the sound quality. All demonstrators answered favorably regarding image quality and 93% (13/14) regarding sound quality. Preparations were completed without any outsourcing at 11 sites (79%) and were evaluated as 'very easy' or 'easy' at all but one site (92.3%). Preparation cost was judged as 'very cheap' or 'cheap' at 12 sites (86%). Live endoscopy connecting multiple international centers was satisfactory in image and sound quality for both audience and demonstrators, with easy and inexpensive preparation. The remote transmission of live endoscopy from demonstrators' own hospitals was preferred to the conventional style of locally organized live endoscopy. © 2015 The Authors Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

  9. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition.

    PubMed

    Agostoni, C; Buonocore, G; Carnielli, V P; De Curtis, M; Darmaun, D; Decsi, T; Domellöf, M; Embleton, N D; Fusch, C; Genzel-Boroviczeny, O; Goulet, O; Kalhan, S C; Kolacek, S; Koletzko, B; Lapillonne, A; Mihatsch, W; Moreno, L; Neu, J; Poindexter, B; Puntis, J; Putet, G; Rigo, J; Riskin, A; Salle, B; Sauer, P; Shamir, R; Szajewska, H; Thureen, P; Turck, D; van Goudoever, J B; Ziegler, E E

    2010-01-01

    The number of surviving children born prematurely has increased substantially during the last 2 decades. The major goal of enteral nutrient supply to these infants is to achieve growth similar to foetal growth coupled with satisfactory functional development. The accumulation of knowledge since the previous guideline on nutrition of preterm infants from the Committee on Nutrition of the European Society of Paediatric Gastroenterology and Nutrition in 1987 has made a new guideline necessary. Thus, an ad hoc expert panel was convened by the Committee on Nutrition of the European Society of Paediatric Gastroenterology, Hepatology, and Nutrition in 2007 to make appropriate recommendations. The present guideline, of which the major recommendations are summarised here (for the full report, see http://links.lww.com/A1480), is consistent with, but not identical to, recent guidelines from the Life Sciences Research Office of the American Society for Nutritional Sciences published in 2002 and recommendations from the handbook Nutrition of the Preterm Infant. Scientific Basis and Practical Guidelines, 2nd ed, edited by Tsang et al, and published in 2005. The preferred food for premature infants is fortified human milk from the infant's own mother, or, alternatively, formula designed for premature infants. This guideline aims to provide proposed advisable ranges for nutrient intakes for stable-growing preterm infants up to a weight of approximately 1800 g, because most data are available for these infants. These recommendations are based on a considered review of available scientific reports on the subject, and on expert consensus for which the available scientific data are considered inadequate.

  10. Effect of a health system's medical error disclosure program on gastroenterology-related claims rates and costs.

    PubMed

    Adams, Megan A; Elmunzer, B Joseph; Scheiman, James M

    2014-04-01

    In 2001, the University of Michigan Health System (UMHS) implemented a novel medical error disclosure program. This study analyzes the effect of this program on gastroenterology (GI)-related claims and costs. This was a review of claims in the UMHS Risk Management Database (1990-2010), naming a gastroenterologist. Claims were classified according to pre-determined categories. Claims data, including incident date, date of resolution, and total liability dollars, were reviewed. Mean total liability incurred per claim in the pre- and post-implementation eras was compared. Patient encounter data from the Division of Gastroenterology was also reviewed in order to benchmark claims data with changes in clinical volume. There were 238,911 GI encounters in the pre-implementation era and 411,944 in the post-implementation era. A total of 66 encounters resulted in claims: 38 in the pre-implementation era and 28 in the post-implementation era. Of the total number of claims, 15.2% alleged delay in diagnosis/misdiagnosis, 42.4% related to a procedure, and 42.4% involved improper management, treatment, or monitoring. The reduction in the proportion of encounters resulting in claims was statistically significant (P=0.001), as was the reduction in time to claim resolution (1,000 vs. 460 days) (P<0.0001). There was also a reduction in the mean total liability per claim ($167,309 pre vs. $81,107 post, 95% confidence interval: 33682.5-300936.2 pre vs. 1687.8-160526.7 post). Implementation of a novel medical error disclosure program, promoting transparency and quality improvement, not only decreased the number of GI-related claims per patient encounter, but also dramatically shortened the time to claim resolution.

  11. Elementary School Technology Education. 46th Yearbook, 1997.

    ERIC Educational Resources Information Center

    Kirkwood, James J., Ed.; Foster, Patrick N., Ed.

    This yearbook explores the relationship between elementary school technology education (ESTE) and the traditional subjects of the curriculum, reports on methods of ESTE implementation, and describes roles of teacher preparation and inservice professional development activities for promoting ESTE. Contents include an introductory chapter; 11…

  12. Elementary School Technology Education. 46th Yearbook, 1997.

    ERIC Educational Resources Information Center

    Kirkwood, James J., Ed.; Foster, Patrick N., Ed.

    This yearbook explores the relationship between elementary school technology education (ESTE) and the traditional subjects of the curriculum, reports on methods of ESTE implementation, and describes roles of teacher preparation and inservice professional development activities for promoting ESTE. Contents include an introductory chapter; 11…

  13. Canadian Association of Gastroenterology - Canadian Institutes of Health Research - pharmaceutical partner postdoctoral operating fellowship programme: an outstanding success that continues to excel!

    PubMed

    McKay, Derek M; Daniels, Sandra

    2003-07-01

    The Canadian Association of Gastroenterology (CAG) postdoctoral fellowship programme was initiated in 1992 with the goal of promoting excellence in Canadian gastroenterological research. With backing from multiple pharmaceutical partners and the Canadian Institutes of Health Research, 87 fellows were funded over the next ten years for a total investment of $8,730,101. Between 1992 and 2000, fellows authored 247 articles; 176 being original research articles, 31 (17.5%) of which appeared in journals with impact factors of greater than 10. As testament to the program's success in developing young scientists, 31 former fellows (36%) have progressed to faculty positions. The fellowship programme continues to be an outstanding success and the flagship of CAG research activities.

  14. A Saudi Gastroenterology Association Position Statement on the Use of Tumor Necrosis Factor-alfa Antagonists for the Treatment of Inflammatory Bowel Disease

    PubMed Central

    Mosli, Mahmoud H.; Al-Harbi, Othman; Feagan, Brian G.; Almadi, Majid A.

    2015-01-01

    The objective of this position statement from the Saudi Gastroenterology Association is to guide gastroenterologists on the use of tumor necrosis factor-alfa (TNF-α) antagonists for the treatment of the idiopathic inflammatory bowel diseases, Crohn's disease, and ulcerative colitis. In this article, we summarize the relevant literature regarding the safety and efficacy of TNF-α antagonists, highlight relevant safety concerns specific to the environment in Saudi Arabia, and provide specific recommendations for the use of these agents. PMID:26228361

  15. Adding Postal Follow-Up to a Web-Based Survey of Primary Care and Gastroenterology Clinic Physician Chiefs Improved Response Rates but not Response Quality or Representativeness.

    PubMed

    Partin, Melissa R; Powell, Adam A; Burgess, Diana J; Haggstrom, David A; Gravely, Amy A; Halek, Krysten; Bangerter, Ann; Shaukat, Aasma; Nelson, David B

    2015-09-01

    This study assessed whether postal follow-up to a web-based physician survey improves response rates, response quality, and representativeness. We recruited primary care and gastroenterology chiefs at 125 Veterans Affairs medical facilities to complete a 10-min web-based survey on colorectal cancer screening and diagnostic practices in 2010. We compared response rates, response errors, and representativeness in the primary care and gastroenterology samples before and after adding postal follow-up. Adding postal follow-up increased response rates by 20-25 percentage points; markedly greater increases than predicted from a third e-mail reminder. In the gastroenterology sample, the mean number of response errors made by web responders (0.25) was significantly smaller than the mean number made by postal responders (2.18), and web responders provided significantly longer responses to open-ended questions. There were no significant differences in these outcomes in the primary care sample. Adequate representativeness was achieved before postal follow-up in both samples, as indicated by the lack of significant differences between web responders and the recruitment population on facility characteristics. We conclude adding postal follow-up to this web-based physician leader survey improved response rates but not response quality or representativeness. © The Author(s) 2013.

  16. Canadian Association of Gastroenterology position statement on screening individuals at average risk for developing colorectal cancer: 2010

    PubMed Central

    Leddin, Desmond J; Enns, Robert; Hilsden, Robert; Plourde, Victor; Rabeneck, Linda; Sadowski, Daniel C; Singh, Harminder

    2010-01-01

    The Canadian Association of Gastroenterology and the Canadian Digestive Health Foundation published guidelines on colon cancer screening in 2004. Subsequent to the publication of these guidelines, many advances have occurred, thereby necessitating a review of the existing guidelines in the context of new technologies and clinical knowledge. The assembled guideline panel recognized three recent American sets of guidelines and identified seven issues that required comment from a Canadian perspective. These issues included, among others, the role of program-based screening, flexible sigmoidoscopy, computed tomography colonography, barium enema and quality improvement. The panel also provided context for the selection of the fecal immunochemical test as the fecal occult blood test of choice, and the relative role of colonoscopy as a primary screening tool. Recommendations were also provided for an upper age limit for colon cancer screening, whether upper endoscopy should be performed following a negative colonoscopy for a positive fecal occult blood test and when colon cancer screening should resume following negative colonoscopy. PMID:21165377

  17. Progress in pediatrics in 2011. Choices in endocrinology, gastroenterology, hemato-oncology, infectious diseases, otolaryngology, pharmacotherapy and respiratory tract illnesses.

    PubMed

    Caffarelli, Carlo; Santamaria, Francesca; Cesari, Silvia; Di Giorgio, Angela; Bernasconi, Sergio

    2012-06-08

    Main progresses in endocrinology, gastroenterology, hemato-oncology, infectious diseases, otolaryngology, pharmacotherapy, and respiratory tract illnesses selected from articles published in The Italian Journal of Pediatrics in 2011 were reviewed. Risk factors for gastroenteritis and appendicitis in developing countries may be useful in improving our understanding of these diseases. Childhood hearing impairment is a world-wide problem which continues to have an high prevalence in newborns. Among the mechanisms of diseases, obese children often have asthma and high hepcidin levels that may reduce serum iron concentrations. In cystic fibrosis, 18q distal deletion has been described as a novel mutation. Hypothyroidism in children with central nervous system infections may increase mortality rates. Infrared tympanic thermometer (IRTT) in oral mode for the measurement of body temperature may be useful in fever screening in a busy setup. In newborns, the transmission of CMV infection through breast milk may be prevented through freezing or pasteurization. Recent advances in treatment of constipation, urinary tract infections, leukemia, pain in children with cancer, neonates with sepsis or difficult weaning from mechanical ventilation will likely contribute towards optimizing management of these common disorders. The work of the Family Pediatricians Medicines for Children Research Network aims to develop competence, infrastructure, networking and education for pediatric clinical trials.

  18. Development of the Society of Gastroenterology Nurses and Associates Minimum Data Set: an evidence-based resource.

    PubMed

    Bean, Kathy B

    2005-01-01

    The Society for Gastroenterology Nurses and Associates (SGNA) has developed a Minimum Data Set identifying the essential elements necessary to document delivery of patient care in the gastrointestinal endoscopic setting. Standardized information, such as a minimum data set, for facilitating communication among practitioners is believed to enhance patient outcomes. The SGNA Minimum Data Set was developed for "public" use to facilitate quality patient outcomes and to enhance the education, research, and clinical practice of GI nurses. Data were collected from a cross-sectional representation of geographic locations and settings (major medical centers, community hospitals, and free-standing clinics) in order to establish a broad evidence-based perspective for the data set. Data for the four primary endoscopic procedures: esophagogastroduodenoscopy (EGD), colonoscopy, endoscopic retrograde cholangiopancreatography (ERCP), and flexible sigmoidoscopy; as well as the most common therapeutic procedures (biopsy, polypectomy, dilation, endoscopic ultrasound [EUS], and manometry/motility) were analyzed to establish the key elements of the Minimum Data Set. Focus groups with members from around the U.S. verified the validity of the Minimum Data Set. The SGNA Minimum Data Set can be used by healthcare institutions, industry, and individuals to facilitate the capture and analysis of standardized data for the purpose of improving GI patient outcomes and enhancing delivery of nursing care.

  19. Progress in pediatrics in 2013: choices in allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses.

    PubMed

    Caffarelli, Carlo; Santamaria, Francesca; Vottero, Alessandra; Dascola, Carlotta Povesi; Mirra, Virginia; Sperli, Francesco; Bernasconi, Sergio

    2014-07-12

    This review will provide new information related to pathophysiology and management of specific diseases that have been addressed by selected articles published in the Italian Journal of Pediatrics in 2013, focusing on allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses in children. Recommendations for interpretation of skin prick test to foods in atopic eczema, management of allergic conjunctivitis, hypertension and breastfeeding in women treated with antiepileptic drugs and healthy breakfast have been reported. Epidemiological studies have given emphasis to high incidence of autoimmune disorders in patients with Turner syndrome, increasing prevalence of celiac disease, frequency of hypertension in adolescents, incidence and risk factor for retinopathy of prematurity. Advances in prevention include elucidation of the role of probiotics in reducing occurrence of allergies and feeding intolerance, and events of foetal life that influence later onset of diseases. Mechanistic studies suggested a role for vitamin D deficiency in asthma and type 1 diabetes and for reactivation of Varicella-Zoster virus in aseptic meningitis. Regarding diagnosis, a new mean for the diagnosis of hyperbilirubinaemia in newborns, a score for recognition of impaired nutritional status and growth and criteria for early Dyke-Davidoff-Masson Syndrome have been suggested. New therapeutic approaches consist of use of etanercept for reducing insulin dose in type 1 diabetes, probiotics in atopic eczema, and melatonin in viral infections.

  20. Rating and issues of mechanical anastomotic staplers in surgical practice: a survey of 241 Japanese gastroenterological surgeons.

    PubMed

    Kono, Emiko; Tomizawa, Yasuko; Matsuo, Tomoko; Nomura, Sachiyo

    2012-10-01

    Commercially available mechanical devices for gastrointestinal anastomosis are mostly made in overseas. Japanese female surgeons have described these devices as being too large and difficult to handle. This study investigated the degree of satisfaction and problems experienced by Japanese surgeons in using various staplers for mechanical anastomosis. A questionnaire was prepared and sent via email to 5,537 members of the Japanese Society of Gastroenterological Surgery. The questionnaire included sex, age, surgical glove size, degree of satisfaction with various mechanical staplers, stress felt when using the staplers in anastomosis, and problems regarding the devices. Valid responses were received from 241 respondents (167 males, 74 females, response rate 4.9 %). The satisfaction rate ranged from 0 to 100 %. The average glove size in males was significantly larger than that in females (median: 7.0 versus 6.0; P < 0.0001). Surgeons with glove size 6.0 or smaller felt stress more frequently than those with size 6.5 or larger (median: 40 vs. 20 %; P < 0.0001). Surgeons with glove size 6.0 and smaller experienced more difficulties during firing and releasing. The satisfaction rates with currently available mechanical staplers were low. Japanese surgeons with small hands felt more stress when using the staplers. Ergonometric consideration is necessary in stapler design.

  1. [Profile of gastrointestinal diseases in a pediatric gastroenterology center in Colombia: 15 years of follow-up].

    PubMed

    Daza, Wilson; Dadan, Silvana; Higuera, Michelle

    2017-09-01

    The profile of gastrointestinal diseases is constantly changing globally and locally affecting suspected diagnosis and medical methods. To establish the main diagnoses in a gastroenterology, hepatology, and pediatric nutrition unit in Bogota between 2009 and 2013, and to compare with findings from the same unit during the two prior five-year periods (1997 to 2006). We conducted a retrospective descriptive study. Medical records were reviewed to extract diagnoses. Data from the two previous five-year periods were taken from institutional records. A univariate analysis was performed, along with calculation of absolute and relative frequencies for qualitative variables, and central tendency and dispersion measures for quantitative variables. The study collected the diagnoses of 1,171 patients, 51.8% (607) of whom were male, and 64% (753/1171), under five years of age. The main diagnoses were: constipation (33.9%), food allergy (23.5%), eating disorders (5.5%), gastroesophageal reflux disease (4.1%), peptic ulcer disease (4.1%), persistent diarrhea (3.8%) and cystic fibrosis (3.4%). Upon comparing this period with the two previous ones, we observed that peptic ulcer disease decreased while constipation, which was in the second position, rose to the first place. Food allergy, not registered within the first ten diagnoses in previous periods, appeared during this last period. During the last five years, constipation was the first gastrointestinal diagnosis followed by food allergy, in agreement with the global trend. It is essential, therefore, to apply diagnostic algorithms, timely treatment, and prevention.

  2. Progress in pediatrics in 2013: choices in allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses

    PubMed Central

    2014-01-01

    This review will provide new information related to pathophysiology and management of specific diseases that have been addressed by selected articles published in the Italian Journal of Pediatrics in 2013, focusing on allergology, endocrinology, gastroenterology, hypertension, infectious diseases, neonatology, neurology, nutrition and respiratory tract illnesses in children. Recommendations for interpretation of skin prick test to foods in atopic eczema, management of allergic conjunctivitis, hypertension and breastfeeding in women treated with antiepileptic drugs and healthy breakfast have been reported. Epidemiological studies have given emphasis to high incidence of autoimmune disorders in patients with Turner syndrome, increasing prevalence of celiac disease, frequency of hypertension in adolescents, incidence and risk factor for retinopathy of prematurity. Advances in prevention include elucidation of the role of probiotics in reducing occurrence of allergies and feeding intolerance, and events of foetal life that influence later onset of diseases. Mechanistic studies suggested a role for vitamin D deficiency in asthma and type 1 diabetes and for reactivation of Varicella-Zoster virus in aseptic meningitis. Regarding diagnosis, a new mean for the diagnosis of hyperbilirubinaemia in newborns, a score for recognition of impaired nutritional status and growth and criteria for early Dyke-Davidoff-Masson Syndrome have been suggested. New therapeutic approaches consist of use of etanercept for reducing insulin dose in type 1 diabetes, probiotics in atopic eczema, and melatonin in viral infections. PMID:25015124

  3. Molecular typing of Clostridium difficile isolates cultured from patient stool samples and gastroenterological medical devices in a single Iranian hospital.

    PubMed

    Azimirad, Masoumeh; Krutova, Marcela; Nyc, Otakar; Hasani, Zahra; Afrisham, Leili; Alebouyeh, Masoud; Zali, Mohammad Reza

    2017-10-01

    This study aimed to characterize Clostridium difficile isolates cultured from stool samples of patients with C. difficile infection (CDI) and swabs from a medical environment in a gastroenterology center in Tehran, Iran. A total of 158 samples (105 stool samples from hospitalized patients and 53 swabs from medical devices and the environment) were collected from January 2011 to August 2011 and investigated for the presence of C. difficile by direct anaerobic culture on a selective media for C. difficile. C. difficile isolates were further characterized by capillary electrophoresis (CE) ribotyping and toxin gene multiplex PCR. Of 158 samples, C. difficile was cultured in 19 of 105 stool samples (18%) and in 4 of 53 swabs (7.5%). C. difficile PCR ribotype (RT) 126 was the most common RT in the study (21.7%). Further RTs were: 001, 003, 014, 017, 029, 039, 081, 103 and 150. RTs 126, 001, 150 were cultured from both the stool samples and swabs of medical devices and the hospital environment which suggest a possible route of transmission. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Design paper: Japan Endoscopy Database (JED): a prospective, big database project related to Gastroenterological Endoscopy in Japan.

    PubMed

    Matsuda, K; Tanaka, K; Fujishiro, M; Saito, Y; Ohtsuka, K; Oda, I; Katada, C; Kato, M; Kida, M; Kobayashi, K; Hoteya, S; Horimatsu, T; Kodashima, S; Matsuda, T; Muto, M; Yamamoto, H; Ryozawa, S; Iwakiri, R; Kutsumi, H; Miyata, H; Kato, M; Haruma, K; Fujimoto, K; Uemura, N; Kaminishi, M; Tajiri, H

    2017-09-14

    The advent of electrical medical records brought image filing systems to many hospitals, as well as electrical endoscopic medical records. However, data integration among multiple different venders has not yet been accomplished. We start the Japan Endoscopic Database (JED) Project endorsed by Japan Gastroenterological Endoscopy Society (JGES) from January 2015. The purposes of this project are as follows: 1) developing the world's largest endoscopic database generated from daily use of the reporting system 2) capturing the actual performance of endoscopic practice in Japan; and 3) standardizing the terminology and fundamental items for the registry of clinical studies. Moreover, the JED project has the potential to automatically collect data about adverse events, competency and evaluation of the residents, and the actual numbers of procedures in nationwide scale, the certification for specialty board system, and so on. We believe that this design paper would be helpful not only for future nationwide researches but also international ones. (UMIN000016093) This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  5. Medical Research Council, Annual Report 1973-74,

    DTIC Science & Technology

    Contents: Cancer research; Immunology and cell biology; Reproduction and endocrinology; Genetics; Gastroenterology; Renal disease; Cardiovascular ... disease ; Nutrition; Prosthetics; Occupational medicine; Epidemiology and social medicine; Neurology; Psychiatry and psychology.

  6. Management of acute liver failure in infants and children: consensus statement of the pediatric gastroenterology chapter, Indian academy of pediatrics.

    PubMed

    Bhatia, Vidyut; Bavdekar, Ashish; Yachha, Surender Kumar

    2013-05-08

    Selected members were requested to prepare guidelines on specific issues, which were reviewed by two other members. These guidelines were then incorporated into a draft statement, which was circulated to all members. On 17th December 2011, Kunwar Viren Oswal round table conference was organized by the Apollo Center for Advanced Pediatrics, Indraprastha Apollo Hospital, New Delhi and the Sub-specialty Chapter of Pediatric Gastroenterology, Indian Academy of Pediatrics. Presentations, ensuing discussions, and opinions expressed by the participants were incorporated into the final draft. To formulate comprehensive evidence based guidelines for management of acute liver failure in India. Viral hepatitis is the leading cause of acute liver failure (ALF) in India. Search for metabolic etiology, particularly in infants and neonates, and in apparently idiopathic cases needs to be done. Planning for early transfer is important as the risks involved with patient transport may increase or even preclude transfer at later stages. Management should be in an intensive care setting in select situations. There is currently insufficient evidence to routinely prescribe branched-chain amino acids, non-absorbable antibiotics or lactulose. Group recommends use of N-acetyl cysteine routinely in patients with ALF. Administration of antibiotics is recommended where infection is present or the likelihood of impending sepsis is high. Enteral nutrition is preferred to parenteral nutrition. Protein restriction is not recommended. An international normalized ratio >4 or Factor V concentration of <25% are the best available criteria for listing for liver transplantation. Overall 40-50% of ALF patients survive without transplantation. Survival in patients fulfilling criteria for liver transplantation and not transplanted is 10-20%. Liver transplantation is a definite treatment for ALF with high one-and five-year survival rates.

  7. American Gastroenterological Association Institute Technical Review on the Role of Therapeutic Drug Monitoring in the Management of Inflammatory Bowel Diseases.

    PubMed

    Vande Casteele, Niels; Herfarth, Hans; Katz, Jeffry; Falck-Ytter, Yngve; Singh, Siddharth

    2017-09-01

    Therapeutic drug monitoring (TDM), which involves measurement of drug or active metabolite levels and anti-drug antibodies, is a promising strategy that can be used to optimize inflammatory bowel disease therapeutics. It is based on the premise that there is a relationship between drug exposure and outcomes, and that considerable inter-individual variability exists in how patients metabolize the drug (pharmacokinetics) and the magnitude and duration of response to therapy (pharmacodynamics). Therefore, the American Gastroenterological Association has prioritized clinical guidelines on the role of TDM in the management of inflammatory bowel disease. To inform these clinical guidelines, this technical review was developed in accordance with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework for interventional and prognostic studies, and focused on the application of TDM for biologic therapy, specifically anti-tumor necrosis factor-α agents, and for thiopurines. Focused questions address the benefits and risks of a strategy of reactive TDM (in patients with active inflammatory bowel disease) to guide treatment changes compared with empiric treatment changes, and the benefits and risks of a strategy of routine proactive TDM (during routine clinical care in patients with quiescent disease) compared with no routine TDM. Additionally, the review addresses the benefits and risks of routine measurement of thiopurine methyltransferase enzyme activity or genotype before starting thiopurine therapy compared with empiric weight-based dosing and explores the performance of different trough drug concentrations for anti-tumor necrosis factor agents and thiopurines to inform clinical decision making when applying TDM in a reactive setting. Due to a paucity of data, this review does not address the role of TDM for more recently approved biologic agents, such as vedolizumab or ustekinumab. Copyright © 2017 AGA Institute. Published by Elsevier

  8. [Improvement of cost allocation in gastroenterology by introduction of a novel service catalogue covering the complete spectrum of endoscopic procedures].

    PubMed

    Rathmayer, M; Scheffer, H; Braun, M; Heinlein, W; Akoglu, B; Brechmann, T; Gölder, S K; Lankisch, T; Messmann, H; Schneider, A; Wagner, M; Fleßa, S; Meier, A; Lewerenz, B; Gossner, L; Faiss, S; Toermer, T; Werner, T; Wilke, M H; Lerch, M M; Schepp, W

    2015-03-01

    The German hospital reimbursement system (G-DRG) is incomplete for endoscopic interventions and fails to differentiate between complex and simple procedures. This is caused by outdated methods of personnel-cost allocation. To establish an up-to-date service catalogue 50 hospitals made their anonymized expense-budget data available to the German-Society-of-Gastroenterology (DGVS). 2.499.900 patient-datasets (2011-2013) were used to classify operation-and-procedure codes (OPS) into procedure-tiers (e.g. colonoscopy with biopsy/colonoscopy with stent-insertion). An expert panel ranked these tiers according to complexity and assigned estimates of physician time. From June to November 2014 exact time tracking data for a total 38.288 individual procedures were collected in 119 hospitals to validate this service catalogue. In this three-step process a catalogue of 97 procedure-tiers was established that covers 99% of endoscopic interventions performed in German hospitals and assigned validated mean personnel-costs using gastroscopy as standard. Previously, diagnostic colonoscopy had a relative personnel-cost value of 1.13 (compared to gastroscopy 1.0) and rose to 2.16, whereas diagnostic ERCP increased from 1.7 to 3.62, more appropriately reflecting complexity. Complex procedures previously not catalogued were now included (e.g. gastric endoscopic submucosal dissection: 16.74). This novel service catalogue for GI-endoscopy almost completely covers all endoscopic procedures performed in German hospitals and assigns relative personnel-cost values based on actual physician time logs. It is to be included in the national coding recommendation and should replace all prior inventories for cost distribution. The catalogue will contribute to a more objective cost allocation and hospital reimbursement - at least until time tracking for endoscopy becomes mandatory. © Georg Thieme Verlag KG Stuttgart · New York.

  9. A Simple Dietary Questionnaire Correlates With Formal Dietitian Evaluation and Frequently Identifies Specific Clinical Interventions in an Outpatient Gastroenterology Clinic.

    PubMed

    Dubin, Sterling M; Vadivelu, Jaya; Copur-Dahi, Nedret; Miranda, Leslie; Palermo, Dana; Pandey, Braj; Groessl, Erik J; Ho, Samuel B

    2016-09-01

    The spectrum of gastroenterology-related diseases related to obesity is growing. Few clinical tools exist to aid in clinician-guided dietary counseling. (1) Develop and validate a 1-page diet history form that would provide information on dietary factors that can contribute to gastrointestinal (GI) illness and to assess adherence to the Mediterranean diet; and (2) evaluate the form in a general GI clinic to determine its potential utility as a clinical tool. A 1-page diet history form was developed and underwent qualitative and quantitative validation in comparison to a formal diet evaluation by a registered dietitian. The form was then evaluated in consecutive patients attending a general GI clinic, and analyzed for overall diet content, compliance with a Mediterranean diet, and presence of high-risk (red flag) dietary behaviors. The form was evaluated in 134 patients. In a validation cohort (n=30) the qualitative dietary components measured were highly concordant with a formal dietary interview. Total daily calorie intake correlated with formal dietary review (R=0.61), but tended to underestimate total calories due to less precision in portion size. The prospective cohort (n=104) patients had a mean body mass index of 29.8. Overall, 52.9% were obese, 50% had metabolic syndrome, and 51% had a primary GI illness directly impacted by dietary factors (gastroesophageal reflux, irritable bowel, fatty liver). Overall, 85.6% of patients documented red flag behaviors. Patients with obesity trended for more red flags than overweight or normal body mass index groups. A 1-page diet questionnaire correlated well with formal dietary assessment and identified clinically relevant dietary interventions in a high percentage of GI patients.

  10. Progress in Pediatrics in 2012: choices in allergy, endocrinology, gastroenterology, hematology, infectious diseases, neurology, nutrition and respiratory tract illnesses.

    PubMed

    Caffarelli, Carlo; Santamaria, Francesca; Vottero, Alessandra; Bernasconi, Sergio

    2013-05-08

    In this review, we summarize the progresses in allergy, endocrinology, gastroenterology, hematology, infectious diseases, neurology, nutrition and respiratory tract illnesses that have been published in The Italian Journal of Pediatrics in 2012. The induction of Treg activity by probiotics might be effective for promoting tolerance towards food allergens. Nasal cytology is useful in patients with rhinitis for diagnosing chronic non-allergic non-infectious diseases. Atopic eczema is associated both with an aberrant skin matrix and impaired systemic immune response. Therefore, isolated topical treatment may have suboptimal effect. Diagnostic work-up of exercise-induced anaphylaxis, including exercise challenge test, is necessary to reach a diagnosis. Studies may support a role for nutrition on prevention of asthma and cardiovascular diseases. Clinicians need to early identify adolescent menstrual abnormalities to minimize sequelae, and to promote health information. In Multiple Endocrine Neoplasia type 2B investigations include acetylcholinesterase study of rectal mucosa followed by the molecular analysis of RET mutation. Low adherence to gluten-free diet and osteopenia are common problems in children with diabetes mellitus type 1 and celiac disease. In infantile colic, laboratory tests are usually unnecessary and the treatment is based on reassurance. Prevalence of obesity and stunting is elucidated by several studies. Evidences are growing that dietetic measures are needed to prevent obesity in children with acute leukemia. Treatment studies for infectious diseases show promise for probiotics along with standard triple therapy in children with Helicobacter pilori infection, while zinc has no effect on pneumonia. Educational programs about the proper management of the febrile child are warranted. A new hour-specific total serum bilirubin nomogram has been shown to be able to predict newborns without hyperbilirubinemia after 48 to 72 hours of life. Newborns with

  11. Serum trough infliximab and anti-infliximab antibodies in a cohort of gastroenterology and rheumatology patients' infliximab therapeutic drug monitoring.

    PubMed

    Barlow, Nicola L; Mohammed, Pervaz; Berg, Jonathan D

    2016-07-01

    Infliximab, a monoclonal antibody directed against tumour necrosis factor, is widely used in the treatment of chronic inflammatory conditions including Crohn's disease and rheumatoid arthritis. Its use is limited by development of anti-infliximab antibodies, which can lead to loss of therapeutic efficacy. Serum infliximab and anti-infliximab antibody measurements have recently become routinely available in the UK. The study aimed to assess the clinical utility of antibodies as an adjunct to trough infliximab. Serum trough infliximab was measured in 201 samples from 108 gastroenterology and rheumatology patients on maintenance infliximab therapy. Results were correlated with C-reactive protein concentrations. Total anti-infliximab antibodies were measured in 164 samples. The median (25th-75th percentile) trough infliximab was 3.7 µg/mL (1.2-5.2 µg/mL) and 23% of samples had a concentration ≤1 µg/mL. A notable proportion had positive anti-infliximab antibodies: 84/164 (51%), which subdivided to 85% and 28% with infliximab ≤1 and >1 µg/mL, respectively.Serum C-reactive protein was found to be significantly higher where infliximab was ≤1 compared to >1 µg/mL (10 mg/L [<5-24 mg/L] vs. <5 mg/L [<5-8 mg/L], P < 0.01), although a strict correlation was not observed. The relationship between trough infliximab and C-reactive protein differed depending on antibody status and there was no association between C-reactive protein and the presence or absence of antibodies. Our findings support measurement of anti-infliximab antibodies only in the context of low infliximab concentrations <1 µg/mL. A higher therapeutic cut-off may be relevant in patients with negative antibodies. Further work is indicated to investigate the clinical significance of positive antibodies with therapeutic infliximab concentrations. © The Author(s) 2015.

  12. [Psychosomatics in gastroenterology].

    PubMed

    Moser, G

    2000-01-01

    Never before has the correlation between psychosocial factors and digestive diseases or disorders been studied more intensively than in the past decade. The following article will provide you with a survey of the major studies, functional gastrointestinal disorders, gastroesophageal reflux disease, peptic ulcer and chronic inflammatory bowel diseases taking into account psychosocial factors. The biopsychosocial model is a remarkable step forward in the process of learning more about these diseases, The integrated way of looking at biological, psychological and social factors has become an absolute must for those who want to fully understand the development and the severity of symptoms as well as diagnostics and therapy of these disorders.

  13. [Uses in gastroenterology].

    PubMed

    Díaz Martín, Juan J; González Jiménez, David

    2015-02-07

    Nowadays, publications on probiotics have increased exponentially. However they usually are heterogeneous, use diverse strains and doses, and different outcomes, making it difficult to generalize their results. On the basis of the currently available literature, the use of probiotics is supported in the following diseases: acute diarrhea, antibiotic-associated diarrhea, irritable bowel syndrome, necrotizing enterocolitis and inflammatory bowel disease (particularly pouchitis). This paper provides an update of the potential role of probiotics in gastrointestinal diseases, in both pediatric and adult patients.

  14. American College of Gastroenterology

    MedlinePlus

    ... of Certification (SAP-MOC) Earn ABIM approved MOC credit when you purchase ACG's Self-Assessment Program-Maintenance ... Maintenance of Certification and AMA PRA Category 1 Credits ™ for each module. Videos of expert discussion for ...

  15. American Gastroenterological Association

    MedlinePlus

    ... Press Release AGA Research Highlights at Digestive Disease Week® 2017 May 3, 2017 Guide for media attending ... Read More Book Master Your IBS: An 8-Week Program to Control the Symptoms of Irritable Bowel ...

  16. Annual Technical Report.

    DTIC Science & Technology

    1982-11-01

    T ’ .. . . . -. . . . , . . . - . ... - -. --- ~ . . . ..... .... IIS~ANNUAL TECHNICAL REPORT K-TO THE OFFICE OF NAVAL RESEARCH CONTRACT No, N00014...RIECIPICHT’S CATC1.O@ NUM@SA 4. TITLE (sn$ S-611fleI) ’I TYPE OP RErPORT A Pimo0o COVEREC, Annual Technical Report Am~4~10/01ZS-9130/26 S.PERFORMING

  17. Annual Energy Review, 2008

    SciTech Connect

    2009-06-01

    The Annual Energy Review (AER) is the Energy Information Administration's (EIA) primary report of annual historical energy statistics. For many series, data begin with the year 1949. Included are statistics on total energy production, consumption, trade, and energy prices; overviews of petroleum, natural gas, coal, electricity, nuclear energy, renewable energy, and international energy; financial and environment indicators; and data unit conversions.

  18. Annual Review of Biophysics.

    PubMed

    Hatzis, Christos

    2013-07-01

    Annual Review of Biophysics Rees D. Dill K., Williamson J., Annual Reviews Palo Alto, CA, 2010. 581 pp. (hardcover), ISBN: 978-0-8243-1839-0, © 2013 Doody's Review Service. Doody's Review Service. © 2013 American Association of Physicists in Medicine.

  19. Annual Data Profile, 1998.

    ERIC Educational Resources Information Center

    Texas Higher Education Coordinating Board, Austin. Community Colleges and Technical Institutes Div.

    This document is a compilation of annual data profile tables, Perkins measures, and institutional effectiveness measures and standards for South Texas Community College, 1998. Data highlights include: (1) total annual enrollment in 1996-97 was 11,508 (872 white; 29 black; 10,526 Hispanic; 69 Asian; 9 Native American; 3 international; and 81…

  20. Annual Partnership Report, 2016

    ERIC Educational Resources Information Center

    Wyoming Community College Commission, 2016

    2016-01-01

    The "Annual Partnership Report" catalogs partnerships that Wyoming community colleges established and maintained for each fiscal year. This partnership report fulfills statutory reporting requirement W.S. 21-18-202(e)(iv) which mandates the development of annual reports to the legislature on the outcomes of partnerships between colleges…

  1. 2010 Annual Report

    SciTech Connect

    2010-01-01

    This annual report includes: an overview of Western; approaches for future hydropower and transmission service; major achievements in FY 2010; FY 2010 customer Integrated Resource Planning, or IRP, survey; and financial data.

  2. TARDEC Annual Report 2010

    DTIC Science & Technology

    2011-06-15

    working on specific technologies, such as automotive capabilities, materials and software development. The benefits of these collaborations are two-fold...ANNUAL REPORT U.S. ARMY TANK AUTOMOTIVE RESEARCH, DEVELOPMENT AND ENGINEERING CENTER TWO THOUSAND TEN Report Documentation Page Form ApprovedOMB No...unlimited 13. SUPPLEMENTARY NOTES Tank- Automotive Research Development and Engineering Center (TARDEC) Fiscal Year (FY) 10 Annual Report 14. ABSTRACT

  3. Natural gas annual 1995

    SciTech Connect

    1996-11-01

    The Natural Gas Annual provides information on the supply and disposition of natural gas to a wide audience including industry, consumers, Federal and State agencies, and educational institutions. The 1995 data are presented in a sequence that follows natural gas (including supplemental supplies) from its production to its end use. This is followed by tables summarizing natural gas supply and disposition from 1991 to 1995 for each Census Division and each State. Annual historical data are shown at the national level.

  4. Natural gas annual 1994

    SciTech Connect

    1995-11-17

    The Natural Gas Annual provides information on the supply and disposition of natural gas to a wide audience including industry, consumers, Federal and State agencies, and educational institutions. The 1994 data are presented in a sequence that follows natural gas (including supplemental supplies) from its production to its end use. This is followed by tables summarizing natural gas supply and disposition from 1990 to 1994 for each Census Division and each State. Annual historical data are shown at the national level.

  5. [Recommendations for the management of pancreatic cancer type adenocarcinoma: A consensus statement reached during the 2015 Latin American Symposium on Gastroenterological Oncology].

    PubMed

    Caglevic, Christian; Gallardo, Jorge; de la Torre, Marcela; Mahave, Mauricio; Müller, Bettina; Solé, Sebastián; Moscoso, Yuri; De La Fuente, Hernán; Roa, Juan Carlos; Hoefler, Sebastián; Butte, Jean M; González M, Pablo; O'Connor, Juan Manuel; Torres, Javiera; Pérez Encalada, Verónica; Alarcón Cano, Daniel; Ubillos, Luis; Rolfo, Christian; Lingua, Alejo; Díaz Romero, Consuelo; Padilla Rosciano, Alejandro; Cuartero, Viviana; Calderillo Ruiz, Germán; Schwartsmann, Gilberto; Kon Jara, Xavier; Andrade G, Andrés; Mas López, Luis; Barajas, Olga; Carballido, Marcela; Lembach, Hanns; Morillas G, Lena; Roca, Enrique; Lobatón, José; Montenegro B, Paola; Yepes, Andrés; Marsiglia, Hugo

    2016-10-01

    Pancreatic cancer is a malignancy of great impact in developed countries and is having an increasing impact in Latin America. Incidence and mortality rates are similar for this cancer. This is an important reason to offer to the patients the best treatments available. During the Latin American Symposium of Gastroenterology Oncology (SLAGO) held in Viña del Mar, Chile, in April 2015, a multidisciplinary group of specialists in the field met to discuss about this disease. The main conclusions of this meeting, where practitioners from most of Latin American countries participated, are listed in this consensus that seek to serve as a guide for better decision making for patients with pancreatic cancer in Latin America.

  6. [Infliximab therapy for Crohn's disease - a practical guideline: actualised consensus of the working group for chronic inflammatory bowel diseases of the Austrian Society for Gastroenterology and Hepatology].

    PubMed

    Reinisch, W; Dejaco, C; Feichtenschlager, T; Haas, T; Kaser, A; Miehsler, W; Novacek, G; Petritsch, W; Platzer, R; Tilg, H; Vogelsang, H; Knoflach, P

    2011-04-01

    Infliximab is a monoclonal antibody against tumor necrosis factor alpha (TNF-α), which is approved for the treatment of chronic inflammatory bowel disease (IBD) such as Crohn's disease (CD), fistulating Crohn's disease (FCD), ulcerative colitis (UC), and paediatric ulcerative colitis (PUC) from 6 years onwards. Besides its therapeutic efficacy, this antibody therapy is characterised by its side effects profile, which has been addressed in a seperate consensus statement by the Working Group for chronic inflammatory bowel diseases within the Austrian Society for Gastroenterology and Hepatology. Infliximab is an effective treatment option for the above-mentioned indications; however, use of this agent requires special knowledge to assess the benefit-risk profile for each patient individually. © Georg Thieme Verlag KG Stuttgart · New York.

  7. [Recommendations on therapy for chronic constipation--working group for functional diagnosis and psychosomatics of the austrian society of gastroenterology and hepatology].

    PubMed

    Vogelsang, H; Pfeiffer, J; Moser, G

    2011-02-01

    Constipation is one of the most frequent gastroenterological problems, especially among elderly people. Chronic constipation is now defined by the new Rome III criteria. Life style counselling is usually only effective in early stages of disease and for mild types. In patients with constipation one should actively screen for possible causative, medically adverse events. Recently new effective opioid antagonists were introduced to act against constipation in patients on long-term opioid therapy. If these actions fail, medical therapy with polyethylene glycol or lactulose should be favoured in the long-term treatment. Psychodiagnostic queries concerning fear should be included in the diagnostic procedures. Biofeedback is an effective therapy in these cases and especially with pelvic floor dyssynergia. Surgical interventions are rarely indicated or successful with the exception of chronic outlet obstruction with severe anatomic changes. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Quality Indicators for the Management of Barrett’s Esophagus, Dysplasia, and Esophageal Adenocarcinoma: International Consensus Recommendations from the American Gastroenterological Association Symposium

    PubMed Central

    Sharma, Prateek; Katzka, David A.; Gupta, Neil; Ajani, Jaffer; Buttar, Navtej; Chak, Amitabh; Corley, Douglas; El-Serag, Hashem; Falk, Gary W.; Fitzgerald, Rebecca; Goldblum, John; Gress, Frank; Ilson, David H.; Inadomi, John M.; Kuipers, Ernest J.; Lynch, John P.; McKeon, Frank; Metz, David; Pasricha, Pankaj J.; Pech, Oliver; Peek, Richard; Peters, Jeffrey H.; Repici, Alessandro; Seewald, Stefan; Shaheen, Nicholas J.; Souza, Rhonda F.; Spechler, Stuart J.; Vennalaganti, Prashanth; Wang, Kenneth

    2016-01-01

    The development of and adherence to quality indicators in gastroenterology, as in all of medicine, is increasing in importance to ensure that patients receive consistent high-quality care. In addition, government-based and private insurers will be expecting documentation of the parameters by which we measure quality, which will likely affect reimbursements. Barrett’s esophagus remains a particularly important disease entity for which we should maintain up-to-date guidelines, given its commonality, potentially lethal outcomes, and controversies regarding screening and surveillance. To achieve this goal, a relatively large group of international experts was assembled and, using the modified Delphi method, evaluated the validity of multiple candidate quality indicators for the diagnosis and management of Barrett’s esophagus. Several candidate quality indicators achieved >80% agreement. These statements are intended to serve as a consensus on candidate quality indicators for those who treat patients with Barrett’s esophagus. PMID:26296479

  9. Pediatric gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Guideline Executive summary.

    PubMed

    Tringali, Andrea; Thomson, Mike; Dumonceau, Jean-Marc; Tavares, Marta; Tabbers, Merit M; Furlano, Raoul; Spaander, Manon; Hassan, Cesare; Tzvinikos, Christos; Ijsselstijn, Hanneke; Viala, Jérôme; Dall'Oglio, Luigi; Benninga, Marc; Orel, Rok; Vandenplas, Yvan; Keil, Radan; Romano, Claudio; Brownstone, Eva; Hlava, Štěpán; Gerner, Patrick; Dolak, Werner; Landi, Rosario; Huber, Wolf Dietrich; Everett, Simon; Vecsei, Andreas; Aabakken, Lars; Amil-Dias, Jorge; Zambelli, Alessandro

    2017-01-01

    This Executive summary of the Guideline on pediatric gastrointestinal endoscopy from the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) refers to infants, children, and adolescents aged 0 - 18 years. The areas covered include: indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileocolonoscopy; endoscopy for foreign body ingestion; endoscopic management of corrosive ingestion and stricture/stenosis; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangiopancreatography, and endoscopic ultrasonography. Percutaneous endoscopic gastrostomy and endoscopy specific to inflammatory bowel disease (IBD) have been dealt with in other Guidelines and are therefore not mentioned in this Guideline. Training and ongoing skill maintenance will be addressed in an imminent sister publication. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Quality indicators for the management of Barrett's esophagus, dysplasia, and esophageal adenocarcinoma: international consensus recommendations from the American Gastroenterological Association Symposium.

    PubMed

    Sharma, Prateek; Katzka, David A; Gupta, Neil; Ajani, Jaffer; Buttar, Navtej; Chak, Amitabh; Corley, Douglas; El-Serag, Hashem; Falk, Gary W; Fitzgerald, Rebecca; Goldblum, John; Gress, Frank; Ilson, David H; Inadomi, John M; Kuipers, Ernest J; Lynch, John P; McKeon, Frank; Metz, David; Pasricha, Pankaj J; Pech, Oliver; Peek, Richard; Peters, Jeffrey H; Repici, Alessandro; Seewald, Stefan; Shaheen, Nicholas J; Souza, Rhonda F; Spechler, Stuart J; Vennalaganti, Prashanth; Wang, Kenneth

    2015-11-01

    The development of and adherence to quality indicators in gastroenterology, as in all of medicine, is increasing in importance to ensure that patients receive consistent high-quality care. In addition, government-based and private insurers will be expecting documentation of the parameters by which we measure quality, which will likely affect reimbursements. Barrett's esophagus remains a particularly important disease entity for which we should maintain up-to-date guidelines, given its commonality, potentially lethal outcomes, and controversies regarding screening and surveillance. To achieve this goal, a relatively large group of international experts was assembled and, using the modified Delphi method, evaluated the validity of multiple candidate quality indicators for the diagnosis and management of Barrett's esophagus. Several candidate quality indicators achieved >80% agreement. These statements are intended to serve as a consensus on candidate quality indicators for those who treat patients with Barrett's esophagus.

  11. Shared care in gastroenterology: GPs' views of open access to out-patient follow-up for patients with inflammatory bowel disease.

    PubMed

    Cheung, W Y; Dove, J; Lervy, B; Russell, I T; Williams, J G

    2002-02-01

    The aim of this study was to ascertain GPs' views about open access to out-patient follow-up for patients with inflammatory bowel disease (IBD). Semi-structured interviews and a postal survey were carried out in general practices in West Glamorgan UK, each with at least one IBD patient taking part in a randomized trial of open access versus routine follow-up, which has been reported elsewhere. A total of 112 GPs from 53 general practices who referred the 180 study patients to specialist gastroenterological care in Neath or Swansea were included in the study. Main outcome measures were GPs' experience of the trial; preferences between methods of out-patient follow-up; and their views about enhancing open access follow-up. Sixty-nine GPs from 40 practices took part in the practice-specific data collection and 91 returned 156 patient-specific questionnaires. They expressed a strong preference for open access follow-up, for both specific patients (108/156 patients) and IBD patients in general (47/69 GPs). Preference for extending open access follow-up to other chronic conditions was not so strong (21/69 GPs). A substantial number of GPs considered their experience of the trial limited (30/69), and few GPs were aware of the shared care guideline distributed before the trial started (8/69). Few GPs encountered any problems in the management of the study patients (9/69) and <50% of the GPs used a Cumulative Encounter Form (29/69) developed for the study. Most GPs were supportive of giving patients written guidelines (56/69) and establishing a gastroenterological (GI) nurse practitioner (45/69). Open access follow-up of patients with IBD is supported by GPs. The approach would probably be improved by the distribution of written information to patients, the establishment of a GI nurse practitioner and an integrated approach between the nurse, hospital specialist, GP and patient.

  12. Scientific publications in gastroenterology and hepatology journals from Chinese authors in various parts of North Asia: 10-year survey of literature.

    PubMed

    Gao, Rui; Liao, Zhuan; Li, Zhao-Shen

    2008-03-01

    People of Chinese ethnicity are one of the groups at most risk of gastrointestinal and liver diseases in the world. The research status in gastroenterology and hepatology (gastrointestinal [GI]) among Chinese individuals in the three major regions of China-the mainland (ML), Hong Kong (HK), and Taiwan (TW)-are unknown. The outputs of articles published in international GI journals from the three regions were compared in this study. Articles published in 52 journals related to GI originating from the ML, TW, and HK from1996-2005 were retrieved from the PubMed database. The numbers of total articles, clinical trials, randomized controlled trials, case reports, impact factors (IF), citation reports, and articles published in the top general medical journals were conducted for quantity and quality comparisons. The number of articles from the three regions increased significantly from 1996 to 2005. There were 5170 articles from the ML (2969), TW (1551), and HK (650). However, nearly 90% of articles from the ML were published in World Journal of Gastroenterology (WJG), a controversial Chinese journal. Following the exclusion of WJG, the ML had published the least number of articles and had the least total citations. The accumulated IF of the articles from TW (3747.893) was much higher than the ML (775.084) and HK (2272.972). HK had the highest average IF of articles in GI journals and the most articles published in the top, general medical journals among the three regions. The difference between the number of GI research articles published in the ML, TW, and HK still appears to be considerable, particularly when assessed by IF, although the gap appears to be narrowing.

  13. European Society for Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Neurological Impairment.

    PubMed

    Romano, Claudio; van Wynckel, Myriam; Hulst, Jessie; Broekaert, Ilse; Bronsky, Jiri; Dall'Oglio, Luigi; Mis, Nataša F; Hojsak, Iva; Orel, Rok; Papadopoulou, Alexandra; Schaeppi, Michela; Thapar, Nikhil; Wilschanski, Michael; Sullivan, Peter; Gottrand, Frédéric

    2017-08-01

    Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, European Society of Gastroenterology, Hepatology and Nutrition aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in children with neurological impairment. Thirty-one clinical questions addressing the diagnosis, treatment, and prognosis of common gastrointestinal and nutritional problems in neurological impaired children were formulated. Questions aimed to assess the nutritional management including nutritional status, identifying undernutrition, monitoring nutritional status, and defining nutritional requirements; to classify gastrointestinal issues including oropharyngeal dysfunctions, motor and sensory function, gastroesophageal reflux disease, and constipation; to evaluate the indications for nutritional rehabilitation including enteral feeding and percutaneous gastrostomy/jejunostomy; to define indications for surgical interventions (eg, Nissen Fundoplication, esophagogastric disconnection); and finally to consider ethical issues related to digestive and nutritional problems in the severely neurologically impaired children. A systematic literature search was performed from 1980 to October 2015 using MEDLINE. The approach of the Grading of Recommendations Assessment, Development, and Evaluation was applied to evaluate the outcomes. During 2 consensus meetings, all recommendations were discussed and finalized. The group members voted on each recommendation using the nominal voting technique. Expert opinion was applied to

  14. ["Epidemiological profile of chronic hepatitis C virus patients and his early virological response to pegylated interferon plus ribavirin therapy. Gastroenterology Service, HNCASE EsSALUD Arequipa"].

    PubMed

    Chirinos de Rivero, Luis Fernando; Campos Nizama, Juan; Castro Valdivia, Raúl; Valdez Herrera, Jesús

    2007-01-01

    The present descriptive, retrospective and longitudinal study was designed to determine the epidemic profile of patients infected by hepatitis C virus and chronic hepatitis, as well as to describe the eligibility criteria for treatment with pegilated interferon plus ribavirina and its early virological answer to the treatment. We studied 20 patients treated at Gastroenterology Service of Carlos Seguín Escobedo Hospital of EsSalud between 2004 and 2006. The diagnosis of HVC infection was confirmed by detection of viral RNA with PCR, and the viral load by counting number of RNA copies. The eligibility criteria for antiviral treatment were determined, and also the METAVIR score to determine hepatic fibrosis. After 12 weeks of treatment the patients with eligibility criteria and received treatment were evaluated, and the effectivity of treatment was evaluated with a new determination of viral load. There were more female (15; 75%) than male patients (5; 25%), with ages between 50 and 59 years. The more frequent risk antecedent was blood transfusion (45%), surgery (35%), and traffic accident (10%). The hematological, hepatic, renal and hormonal parameters were in normal range; and the viral load at the moment of diagnosis was of 580 thousand copies mean (between 4100 to 2 millions copies). The most frequent viral genotypes were 1a and 1b. Up to 40% of patients did not fulfilled eligibility criteria for treatment. Nine of 12 patients with eligibility criteria received treatment (75%), 6 of them were evaluated for early virologic response and of them 100,0% had an early virologic response with decrease of post-therapeutic viral load in all but one cases until non-detectable levels. In conclusion our study described the profile of patients infected by HCV with chronic hepatitis in gastroenterology ward of our hospital, and it has been determined that is suggestive that antiviral treatment is highly effective in patients with eligibility criteria for treatment, related to

  15. Natural gas annual 1997

    SciTech Connect

    1998-10-01

    The Natural Gas Annual provides information on the supply and disposition of natural gas to a wide audience including industry, consumers, Federal and State agencies, and educational institutions. The 1997 data are presented in a sequence that follows natural gas (including supplemental supplies) from its production to its end use. This is followed by tables summarizing natural gas supply and disposition from 1993 to 1997 for each Census Division and each State. Annual historical data are shown at the national level. 27 figs., 109 tabs.

  16. International energy annual 1996

    SciTech Connect

    1998-02-01

    The International Energy Annual presents an overview of key international energy trends for production, consumption, imports, and exports of primary energy commodities in over 220 countries, dependencies, and areas of special sovereignty. Also included are population and gross domestic product data, as well as prices for crude oil and petroleum products in selected countries. Renewable energy reported in the International Energy Annual includes hydroelectric power, geothermal, solar, and wind electric power, biofuels energy for the US, and biofuels electric power for Brazil. New in the 1996 edition are estimates of carbon dioxide emissions from the consumption of petroleum and coal, and the consumption and flaring of natural gas. 72 tabs.

  17. ASE Annual Conference 2010

    ERIC Educational Resources Information Center

    McCune, Roger

    2010-01-01

    In this article, the author describes the ASE Annual Conference 2010 which was held at Nottingham after a gap of 22 years. As always, the main conference was preceded by International Day, an important event for science educators from across the world. There were two strands to the programme: (1) "What works for me?"--sharing new ideas…

  18. Annual Research Briefs - 1996

    NASA Technical Reports Server (NTRS)

    1996-01-01

    This report contains the 1996 annual progress reports of the research fellows and students supported by the Center for Turbulence Research. Last year, CTR hosted twelve resident Postdoctoral Fellows, three Research Associates, four Senior Research Fellows, and supported one doctoral student and ten short term visitors.

  19. TACSCE Research Annual 1991.

    ERIC Educational Resources Information Center

    Lesko, Silvia Jo

    1991-01-01

    This annual contains the paper that won the 1991 President's Award of the Texas Association for Community Service and Continuing Education (TACSCE) as well as the runner-up paper and other articles. An editorial, "Learning to Crawl" (Silvia Lesko), focuses on the editor's "discovery" of the adult learner. "Ethics and…

  20. NERSC Annual Report 2005

    SciTech Connect

    Hules , John

    2006-07-31

    The National Energy Research Scientific Computing Center (NERSC) is the premier computational resource for scientific research funded by the DOE Office of Science. The Annual Report includes summaries of recent significant and representative computational science projects conducted on NERSC systems as well as information about NERSC's current and planned systems and services.

  1. Carolinas Communication Annual, 1998.

    ERIC Educational Resources Information Center

    McLennan, David B.

    1998-01-01

    This 1998 issue of "Carolinas Communication Annual" contains the following articles: "Give Me That Old Time Religion?: A Study of Religious Themes in the Rhetoric of the Ku Klux Klan" (John S. Seiter); "The Three Stooges versus the Third Reich" (Roy Schwartzman); "Interdisciplinary Team Teaching: Implementing…

  2. UNICEF Annual Report, 1994.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    This annual report for the United Nations Children's Fund (UNICEF) describes the programs and services provided by this organization in 1993. Following an introduction by UNICEF's executive director, the report reviews regional developments in Sub-Saharan Africa, the Middle East and North Africa, East Asia and the Pacific, South Asia, Latin…

  3. Folklife Annual, 1987.

    ERIC Educational Resources Information Center

    Jabbour, Alan, Ed.; Hardin, James, Ed.

    This annual publication is intended to promote the documentation and study of the folklife of the United States, to share the traditions, values, and activities of U.S. folk culture, and to serve as a national forum for the discussion of ideas and issues in folklore and folklife. The articles in this collection are: (1) "Eating in the Belly…

  4. NERSC Annual Report 2004

    SciTech Connect

    Hules, John; Bashor, Jon; Yarris, Lynn; McCullough, Julie; Preuss, Paul; Bethel, Wes

    2005-04-15

    The National Energy Research Scientific Computing Center (NERSC) is the premier computational resource for scientific research funded by the DOE Office of Science. The Annual Report includes summaries of recent significant and representative computational science projects conducted on NERSC systems as well as information about NERSC's current and planned systems and services.

  5. Ultrasound Annual, 1984

    SciTech Connect

    Sanders, R.C.; Hill, M.C.

    1984-01-01

    The 1984 edition of Ultrasound Annual explores new applications of ultrasound in speech and swallowing and offers guidelines on the use of ultrasound and nuclear medicine in thyroid and biliary tract disease. Other areas covered include Doppler sonography of the abdomen, intraoperative abdominal ultrasound, sonography of the placenta, ultrasound of the neonatal head and abdomen, and sonographic echo patterns created by fat.

  6. NRCC annual report, 1979

    SciTech Connect

    Not Available

    1980-11-01

    This annual report of the National Research for Computation in Chemistry (NRCC) Division describes the program of research workshops, software development, and scientific research of the Division in 1979. This year marked the first full calendar year of activity of the Division. Initial staffing in the core scientific areas was completed by the addition of a crystallographer.

  7. UNICEF Annual Report, 1993.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    This annual report for the United Nations Children's Fund (UNICEF) details the programs and services provided by this organization in 1992-93. Following an introduction by UNICEF's executive director, the report briefly reviews UNICEF activities for 1992, then describes specific projects in the following areas: (1) child survival and development;…

  8. UNICEF Annual Report 1983.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    In introducing this annual report, the executive director of UNICEF delineates the four techniques for primary health care and basic services reported in the publication "State of the World's Children, 1982-1983." The ensuing review of UNICEF's activities illustrates highlights of the year's program cooperation, including trends and key…

  9. Annual Report, FY 1978.

    ERIC Educational Resources Information Center

    Maryland State Board for Community Colleges, Annapolis.

    This annual report from the Maryland State Board for Community Colleges outlines information on enrollment, instructional programs, finance, capital construction, the state master plan, legislation, and the Vocational Education Acts Grant for fiscal year 1978. The report reveals that the 1977 opening fall credit enrollment for Maryland community…

  10. Annual Energy Outlook

    EIA Publications

    2017-01-01

    The Annual Energy Outlook provides modeled projections of domestic energy markets through 2050, and includes cases with different assumptions of macroeconomic growth, world oil prices, technological progress, and energy policies. With strong domestic production and relatively flat demand, the United States becomes a net energy exporter over the projection period in most cases.

  11. Annual Income Tax Guide.

    ERIC Educational Resources Information Center

    Keener, Sandra C.

    1992-01-01

    This annual guide to income tax for parents of children with disabilities covers organizing records; avoiding audits; deducting medical expenses; and considering the impact of recent changes in medical expenses, Social Security numbers for children, child care, earned income credit, and deduction for dependents. (DB)

  12. NERSC Annual Report 2002

    SciTech Connect

    Hules, John

    2003-01-31

    The National Energy Research Scientific Computing Center (NERSC) is the primary computational resource for scientific research funded by the DOE Office of Science. The Annual Report for FY2002 includes a summary of recent computational science conducted on NERSC systems (with abstracts of significant and representative projects), and information about NERSC's current and planned systems and service

  13. Annual Conference Abstracts

    ERIC Educational Resources Information Center

    Journal of Engineering Education, 1972

    1972-01-01

    Includes abstracts of papers presented at the 80th Annual Conference of the American Society for Engineering Education. The broad areas include aerospace, affiliate and associate member council, agricultural engineering, biomedical engineering, continuing engineering studies, chemical engineering, civil engineering, computers, cooperative…

  14. OMS 1987 Annual Report.

    ERIC Educational Resources Information Center

    Association of Research Libraries, Washington, DC. Office of Management Studies.

    Designed to serve both as an activity report on Office of Management Studies (OMS) progress during 1987 and a catalog of OMS services and products, this annual report focuses on the management of technology in a scholarly environment. Programs and services are reported in five sections: (1) Applied Research and Development (the Institute on…

  15. Annual Energy Outlook

    EIA Publications

    2017-01-01

    The Annual Energy Outlook provides modeled projections of domestic energy markets through 2050, and includes cases with different assumptions of macroeconomic growth, world oil prices, technological progress, and energy policies. With strong domestic production and relatively flat demand, the United States becomes a net energy exporter over the projection period in most cases.

  16. Annual Conference Abstracts

    ERIC Educational Resources Information Center

    Journal of Engineering Education, 1972

    1972-01-01

    Includes abstracts of papers presented at the 80th Annual Conference of the American Society for Engineering Education. The broad areas include aerospace, affiliate and associate member council, agricultural engineering, biomedical engineering, continuing engineering studies, chemical engineering, civil engineering, computers, cooperative…

  17. 2010 AAUW Annual Report

    ERIC Educational Resources Information Center

    American Association of University Women, 2010

    2010-01-01

    This report highlights some of the outstanding accomplishments of AAUW (American Association of University Women) for fiscal year 2010. This year's annual report also features stories of remarkable women who are leading the charge to break through barriers and ensure that all women have a fair chance. Sharon is working to reduce the pay gap…

  18. UNICEF Annual Report, 1994.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    This annual report for the United Nations Children's Fund (UNICEF) describes the programs and services provided by this organization in 1993. Following an introduction by UNICEF's executive director, the report reviews regional developments in Sub-Saharan Africa, the Middle East and North Africa, East Asia and the Pacific, South Asia, Latin…

  19. International Energy Annual, 1992

    SciTech Connect

    Not Available

    1994-01-14

    This report is prepared annually and presents the latest information and trends on world energy production and consumption for petroleum, natural gas, coal, and electricity. Trade and reserves are shown for petroleum, natural gas, and coal. Prices are included for selected petroleum products. Production and consumption data are reported in standard units as well as British thermal units (Btu) and joules.

  20. Annual Coal Distribution

    EIA Publications

    2016-01-01

    The Annual Coal Distribution Report (ACDR) provides detailed information on domestic coal distribution by origin state, destination state, consumer category, and method of transportation. Also provided is a summary of foreign coal distribution by coal-producing state. All data for the report year are final and this report supersedes all data in the quarterly distribution reports.

  1. Grassroots. Annual Report 1993.

    ERIC Educational Resources Information Center

    Grassroots Educare Trust, Gatesville (South Africa).

    This annual report describes the programs and staff for 1993 of Grassroots Educare Trust, an organization that helps South African communities provide preschool education and health care. Contents of the report are: (1) a list of the board of trustees; (2) a message from the chairman; (3) the director's report on external efforts and internal…

  2. Annual Conference Abstracts

    ERIC Educational Resources Information Center

    Engineering Education, 1976

    1976-01-01

    Presents the abstracts of 158 papers presented at the American Society for Engineering Education's annual conference at Knoxville, Tennessee, June 14-17, 1976. Included are engineering topics covering education, aerospace, agriculture, biomedicine, chemistry, computers, electricity, acoustics, environment, mechanics, and women. (SL)

  3. Annual research briefs, 1994

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Briefs of the 1994 annual progress reports of the Research Fellows and students of the Center for Turbulence Research are presented. Subjects covered include turbulence combustion, large eddy simulation, Reynolds-averaged turbulence modeling, turbulence control, postprocessing, sound generation, and turbulence physics.

  4. NUFFIC Annual Report, 1977.

    ERIC Educational Resources Information Center

    Netherlands Universities Foundation for International Co-operation, The Hague.

    The 1977 annual report of the Netherlands Universities Foundation for International Cooperation (NUFFIC) considers the following topics: major developments in work and policy; relationships NUFFIC has with other organizations; University Development Cooperation; developments in international education; the functioning of the Consultative Structure…

  5. UNICEF Annual Report. 1984.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    This annual report reviews the work UNICEF has been doing to help transform the "Child Survival Revolution" from a dream into a reality. Discussion focuses primarily on child health and nutrition and other basic services for children. Throughout, the review is supplemented with profiles of program initiatives made to improve the…

  6. UNICEF Annual Report 1983.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    In introducing this annual report, the executive director of UNICEF delineates the four techniques for primary health care and basic services reported in the publication "State of the World's Children, 1982-1983." The ensuing review of UNICEF's activities illustrates highlights of the year's program cooperation, including trends and key…

  7. UNICEF Annual Report. 1984.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    This annual report reviews the work UNICEF has been doing to help transform the "Child Survival Revolution" from a dream into a reality. Discussion focuses primarily on child health and nutrition and other basic services for children. Throughout, the review is supplemented with profiles of program initiatives made to improve the…

  8. UNICEF Annual Report, 1996.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    At this time, the United Nations Children Fund (UNICEF) is commemorating its 50th anniversary, under the slogan "children first." This annual UNICEF report reviews the organization's activities during 1995. An introduction by the executive director states that the report will give readers a sense of what UNICEF is doing with partners to…

  9. Carolinas Communication Annual, 1999.

    ERIC Educational Resources Information Center

    McLennan, David B.

    1999-01-01

    This 1999 issue of the "Carolinas Communication Annual" contains the following articles: "The Unmade Analogy: Alcohol and Abortion" (Richard W. Leeman); "Say, You Want a Revolution" (Roy Schwartzman and Constance Y. Green); "Exploring the Relationship between Perceived Narrativity and Persuasiveness"…

  10. ASE Annual Conference 2010

    ERIC Educational Resources Information Center

    McCune, Roger

    2010-01-01

    In this article, the author describes the ASE Annual Conference 2010 which was held at Nottingham after a gap of 22 years. As always, the main conference was preceded by International Day, an important event for science educators from across the world. There were two strands to the programme: (1) "What works for me?"--sharing new ideas…

  11. Uranium industry annual 1998

    SciTech Connect

    1999-04-22

    The Uranium Industry Annual 1998 (UIA 1998) provides current statistical data on the US uranium industry`s activities relating to uranium raw materials and uranium marketing. It contains data for the period 1989 through 2008 as collected on the Form EIA-858, ``Uranium Industry Annual Survey.`` Data provides a comprehensive statistical characterization of the industry`s activities for the survey year and also include some information about industry`s plans and commitments for the near-term future. Data on uranium raw materials activities for 1989 through 1998, including exploration activities and expenditures, EIA-estimated reserves, mine production of uranium, production of uranium concentrate, and industry employment, are presented in Chapter 1. Data on uranium marketing activities for 1994 through 2008, including purchases of uranium and enrichment services, enrichment feed deliveries, uranium fuel assemblies, filled and unfilled market requirements, and uranium inventories, are shown in Chapter 2. The methodology used in the 1998 survey, including data edit and analysis, is described in Appendix A. The methodologies for estimation of resources and reserves are described in Appendix B. A list of respondents to the ``Uranium Industry Annual Survey`` is provided in Appendix C. The Form EIA-858 ``Uranium Industry Annual Survey`` is shown in Appendix D. For the readers convenience, metric versions of selected tables from Chapters 1 and 2 are presented in Appendix E along with the standard conversion factors used. A glossary of technical terms is at the end of the report. 24 figs., 56 tabs.

  12. Magnetic Resonance Annual, 1985

    SciTech Connect

    Kressel, H.Y.

    1985-01-01

    The inaugural volume of Magnetic Resonance Annual includes reviews of MRI of the posterior fossa, cerebral neoplasms, and the cardiovascular and genitourinary systems. A chapter on contrast materials outlines the mechanisms of paramagnetic contrast enhancement and highlights several promising contrast agents.

  13. A 25-year analysis of the American College of Gastroenterology research grant program: factors associated with publication and advancement in academics.

    PubMed

    Crockett, Seth D; Dellon, Evan S; Bright, Stephanie D; Shaheen, Nicholas J

    2009-05-01

    The American College of Gastroenterology (ACG) has awarded research grants for 25 years. We assessed the characteristics of grant recipients, their current academic status, and the likelihood of publication resulting from the grant. Demographic data, the year and amount of award, title of project, and recipient's institution were extracted from ACG databases. Using ACG reports and medical literature search engines, we assessed publication based on grant-funded research, as well as career publication record. We also determined the current position of awardees. A similar analysis was performed for recipients of junior investigator awards. A total of 396 clinical research awards totaling $5,374,497 ($6,867,937 in 2008 dollars) were awarded to 341 recipients in the 25 years between 1983 and 2008. The most commonly funded areas of research were endoscopy (22% of awards) and motility/functional disorders (21%). At least one peer-reviewed publication based on grant-funded research occurred with 255 of the 368 awards (69%) for 1983-2006 [corrected]. Higher award value was associated with subsequent publication. Of the 313 awardees over the same period, 195 (62%) are currently in academic positions [corrected]. Factors associated with staying in academics included higher award value (P < 0.01), a Master's degree (P = 0.02), and publishing grant-funded research (P < 0.01). The junior faculty career development award was granted to 27 individuals for a total of $3,000,000 (3,398,004 in 2008 dollars). Publication resulted from 90% of the funded projects, and 95% of awardees have remained in academics. Overall, the mean cost in grant dollars per published paper based on the research was $14,875. The majority of ACG grant recipients published the results of their research and remained in academics. Higher amount of award, holding an advanced degree, and publication were associated with careers in academics. The ACG research grant award program is an important engine of

  14. Annual recertification: fun? Wow!

    PubMed

    Amos, A

    1994-01-01

    Learning is critical to fostering a knowledge base required for maintaining currency and furthering professional development. In the ever-changing field of nephrology, most skills practised in nursing are considered to be sanctioned medical acts or added nursing skills. Therefore, annual recertification of the skills designated as sanctioned medical acts is an expectation of the College of Nurses of Ontario. The Wellesley Hospital policy indicates one time only or annual approval of the added nursing skills. The article will discuss the use of games as a creative, non-threatening educational tool in the recertification/re-approval process currently in place at The Wellesley Hospital, renal programs. In the past two years, several games or alternative teaching strategies have been utilized to assist the staff in preparing for recertification. This paper will examine the advantages and disadvantages of utilizing alternative teaching formats. Commentary regarding the response of staff nurses, nursing management and education will be highlighted.

  15. Annual Energy Review 2007

    SciTech Connect

    Seiferlein, Katherine E.

    2008-06-01

    The Annual Energy Review (AER) is the Energy Information Administration's (EIA) primary report of annual historical energy statistics. For many series, data begin with the year 1949. Included are data on total energy production, consumption, and trade; overviews of petroleum, natural gas, coal, electricity, nuclear energy, renewable energy, international energy, as well as financial and environment indicators; and data unit conversion tables. Publication of this report is required under Public Law 95–91 (Department of Energy Organization Act), Section 205(c), and is in keeping with responsibilities given to the EIA under Section 205(a)(2), which states: “The Administrator shall be responsible for carrying out a central, comprehensive, and unified energy data and information program which will collect, evaluate, assemble, analyze, and disseminate data and information....”

  16. Coal industry annual 1997

    SciTech Connect

    1998-12-01

    Coal Industry Annual 1997 provides comprehensive information about US coal production, number of mines, prices, productivity, employment, productive capacity, and recoverable reserves. US Coal production for 1997 and previous years is based on the annual survey EIA-7A, Coal Production Report. This report presents data on coal consumption, coal distribution, coal stocks, coal prices, and coal quality for Congress, Federal and State agencies, the coal industry, and the general public. Appendix A contains a compilation of coal statistics for the major coal-producing States. This report includes a national total coal consumption for nonutility power producers that are not in the manufacturing, agriculture, mining, construction, or commercial sectors. 14 figs., 145 tabs.

  17. Renewable energy annual 1995

    SciTech Connect

    1995-12-01

    The Renewable Energy Annual 1995 is the first in an expected series of annual reports the Energy Information Administration (EIA) intends to publish to provide a comprehensive assessment of renewable energy. This report presents the following information on the history, status, and prospects of renewable energy data: estimates of renewable resources; characterizations of renewable energy technologies; descriptions of industry infrastructures for individual technologies; evaluations of current market status; and assessments of near-term prospects for market growth. An international section is included, as well as two feature articles that discuss issues of importance for renewable energy as a whole. The report also contains a number of technical appendices and a glossary. The renewable energy sources included are biomass (wood), municipal solid waste, biomass-derived liquid fuels, geothermal, wind, and solar and photovoltaic.

  18. International energy annual 1997

    SciTech Connect

    1999-04-01

    The International Energy Annual presents an overview of key international energy trends for production, consumption, imports, and exports of primary energy commodities in over 220 countries, dependencies, and areas of special sovereignty. Also included are population and gross domestic product data, as well as prices for crude oil and petroleum products in selected countries. Renewable energy reported in the International Energy Annual includes hydroelectric power and geothermal, solar, and wind electric power. Also included are biomass electric power for Brazil and the US, and biomass, geothermal, and solar energy produced in the US and not used for electricity generation. This report is published to keep the public and other interested parties fully informed of primary energy supplies on a global basis. The data presented have been largely derived from published sources. The data have been converted to units of measurement and thermal values (Appendices E and F) familiar to the American public. 93 tabs.

  19. Petroleum marketing annual 1994

    SciTech Connect

    1995-08-24

    The Petroleum Marketing Annual (PMA) provides information and statistical data on a variety of crude oils and refined petroleum products. The publication presents statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysis, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the fob and landed cost of imported crude oil, and the refiners` acquisition cost of crude oil. Refined petroleum product sales data include motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane. The Petroleum Marketing Division, Office of Oil and Gas, Energy Information Administration ensures the accuracy, quality, and confidentiality of the published data in the Petroleum Marketing Annual. For this production, all estimates have been recalculated since their earlier publication in the Petroleum Marketing Monthly (PMM). These calculations made use of additional data and corrections that were received after the PMM publication date.

  20. NSLS annual report 1984

    SciTech Connect

    Klaffky, R.; Thomlinson, W.

    1984-01-01

    The first comprehensive Annual Report of the National Synchrotron Light Source comes at a time of great activity and forward motion for the facility. In the following pages we outline the management changes that have taken place in the past year, the progress that has been made in the commissioning of the x-ray ring and in the enhanced utilization of the uv ring, together with an extensive discussion of the interesting scientific experiments that have been carried out.

  1. 2008 annual merit review

    SciTech Connect

    None, None

    2009-01-18

    The 2008 DOE Vehicle Technologies Program Annual Merit Review was held February 25-28, 2008 in Bethesda, Maryland. The review encompassed all of the work done by the Vehicle Technologies Program: a total of 280 individual activities were reviewed, by a total of just over 100 reviewers. A total of 1,908 individual review responses were received for the technical reviews, and an additional 29 individual review responses were received for the plenary session review.

  2. Uranium industry annual 1995

    SciTech Connect

    1996-05-01

    The Uranium Industry Annual 1995 (UIA 1995) provides current statistical data on the U.S. uranium industry`s activities relating to uranium raw materials and uranium marketing. The UIA 1995 is prepared for use by the Congress, Federal and State agencies, the uranium and nuclear electric utility industries, and the public. It contains data for the period 1986 through 2005 as collected on the Form EIA-858, ``Uranium Industry Annual Survey``. Data collected on the ``Uranium Industry Annual Survey`` provide a comprehensive statistical characterization of the industry`s plans and commitments for the near-term future. Where aggregate data are presented in the UIA 1995, care has been taken to protect the confidentiality of company-specific information while still conveying accurate and complete statistical data. Data on uranium raw materials activities for 1986 through 1995 including exploration activities and expenditures, EIA-estimated reserves, mine production of uranium, production of uranium concentrate, and industry employment are presented in Chapter 1. Data on uranium marketing activities for 1994 through 2005, including purchases of uranium and enrichment services, enrichment feed deliveries, uranium fuel assemblies, filled and unfilled market requirements, uranium imports and exports, and uranium inventories are shown in Chapter 2. The methodology used in the 1995 survey, including data edit and analysis, is described in Appendix A. The methodologies for estimation of resources and reserves are described in Appendix B. A list of respondents to the ``Uranium Industry Annual Survey`` is provided in Appendix C. For the reader`s convenience, metric versions of selected tables from Chapters 1 and 2 are presented in Appendix D along with the standard conversion factors used. A glossary of technical terms is at the end of the report. 14 figs., 56 tabs.

  3. NERSC 2001 Annual Report

    SciTech Connect

    Hules, John

    2001-12-12

    The National Energy Research Scientific Computing Center (NERSC) is the primary computational resource for scientific research funded by the DOE Office of Science. The Annual Report for FY2001 includes a summary of recent computational science conducted on NERSC systems (with abstracts of significant and representative projects); information about NERSC's current systems and services; descriptions of Berkeley Lab's current research and development projects in applied mathematics, computer science, and computational science; and a brief summary of NERSC's Strategic Plan for 2002-2005.

  4. NERSC 1998 annual report

    SciTech Connect

    Hules, John

    1999-03-01

    This 1998 annual report from the National Scientific Energy Research Computing Center (NERSC) presents the year in review of the following categories: Computational Science; Computer Science and Applied Mathematics; and Systems and Services. Also presented are science highlights in the following categories: Basic Energy Sciences; Biological and Environmental Research; Fusion Energy Sciences; High Energy and Nuclear Physics; and Advanced Scientific Computing Research and Other Projects.

  5. Annual Report 1984.

    DTIC Science & Technology

    1985-01-01

    quality activities, and coordinating activities with other Federal and non-Federal basin interests groups. - , DD Fo’N, 1473 EDITION Ort NOV6S IS...Sod•’ I TABLE OF CONTENTS (CONTINUED) PAGE SECTION VII- RESERVOIR DATA SUMMARY 1. SWD MAP 2. INDEX BY BASINS 3. INDEX IN ALPHABETICAL ORDER 4. DATA...TABLES SECTION VIII - MINUTES OF THE TRINITY RIVER BASIN INTERESTS GROUP AND THE ANNUAL SWD WATER MANAGEMENT PERSONNEL MEETING 1. TRINITY RIVER BASIN

  6. Uranium industry annual 1994

    SciTech Connect

    1995-07-05

    The Uranium Industry Annual 1994 (UIA 1994) provides current statistical data on the US uranium industry`s activities relating to uranium raw materials and uranium marketing during that survey year. The UIA 1994 is prepared for use by the Congress, Federal and State agencies, the uranium and nuclear electric utility industries, and the public. It contains data for the 10-year period 1985 through 1994 as collected on the Form EIA-858, ``Uranium Industry Annual Survey.`` Data collected on the ``Uranium Industry Annual Survey`` (UIAS) provide a comprehensive statistical characterization of the industry`s activities for the survey year and also include some information about industry`s plans and commitments for the near-term future. Where aggregate data are presented in the UIA 1994, care has been taken to protect the confidentiality of company-specific information while still conveying accurate and complete statistical data. A feature article, ``Comparison of Uranium Mill Tailings Reclamation in the United States and Canada,`` is included in the UIA 1994. Data on uranium raw materials activities including exploration activities and expenditures, EIA-estimated resources and reserves, mine production of uranium, production of uranium concentrate, and industry employment are presented in Chapter 1. Data on uranium marketing activities, including purchases of uranium and enrichment services, and uranium inventories, enrichment feed deliveries (actual and projected), and unfilled market requirements are shown in Chapter 2.

  7. 13CO2/12CO2 ratio analysis in exhaled air by lead-salt tunable diode lasers for noninvasive diagnostics in gastroenterology

    NASA Astrophysics Data System (ADS)

    Stepanov, Eugene V.; Zyrianov, Pavel V.; Miliaev, Valerii A.; Selivanov, Yurii G.; Chizhevskii, Eugene G.; Os'kina, Svetlana; Ivashkin, Vladimir T.; Nikitina, Elena I.

    1999-07-01

    An analyzer of 13CO2/12CO2 ratio in exhaled air based on lead-salt tunable diode lasers is presented. High accuracy of the carbon isotope ratio detection in exhaled carbon dioxide was achieved with help of very simple optical schematics. It was based on the use of MBE laser diodes operating in pulse mode and on recording the resonance CO2 absorption at 4.2 micrometers . Special fast acquisition electronics and software were applied for spectral data collection and processing. Developed laser system was tested in a clinical train aimed to assessment eradication efficiency in therapy of gastritis associated with Helicobacter pylori infection. Data on the 13C-urea breath test used for P.pylori detection and obtained with tunable diode lasers in the course of the trail was compared with the results of Mass-Spectroscopy analysis and histology observations. The analyzer can be used also for 13CO2/12CO2 ratio detection in exhalation to perform gastroenterology breath test based on using other compounds labeled with stable isotopes.

  8. Relationship between upper gastrointestinal symptoms and lifestyle, psychosocial factors and comorbidity in the general population: results from the Domestic/International Gastroenterology Surveillance Study (DIGEST).

    PubMed

    Stanghellini, V

    1999-01-01

    The Domestic/International Gastroenterology Surveillance Study (DIGEST) investigated the prevalence and economic/quality-of-life impact of upper gastrointestinal (GI) symptoms over 3 months among the general population of seven international sites (n = 5581). Respondents were classified as having relevant or non-relevant symptoms, and were further classified as having gastro-oesophageal reflux disease (GORD)-, ulcer-, or dysmotility-like symptoms, based on their most bothersome symptom. Associations were investigated between the prevalence of relevant upper GI symptoms and these subtypes, and the following potential risk factors: psychosocial variables (income, educational level, marital status, having children, occupation, any significant life event during previous year); lifestyle variables (tobacco use, levels of alcohol and caffeine consumption); comorbidity variables (illnesses or symptoms experienced in the previous 3 months, concurrent conditions diagnosed by a doctor, prescriptions and over-the-counter (OTC) medications taken in the previous 3 months for health problems other than upper GI symptoms). The most notable risk factors for the occurrence of upper GI symptoms, including symptoms indicative of GORD, were found to be various indicators of psychological stress (particularly recent life events) and psychiatric disease. A wide range of other non-psychiatric illnesses and their treatments was also clearly associated with the occurrence of upper GI symptoms, consistent with these symptoms occurring in many organic illnesses or as adverse effects of their treatments. Smoking was also found to be associated with GORD-like symptoms.

  9. [Adalimumab for the treatment of ulcerative colitis--a consensus report by the working group inflammatory bowel diseases of the Austrian Society of Gastroenterology and Hepatology].

    PubMed

    Novacek, G; Dejaco, C; Knoflach, P; Moschen, A; Petritsch, W; Vogelsang, H; Reinisch, W

    2014-02-01

    TNF alpha antibodies have clearly improved the outcome of moderately to severely active ulcerative colitis. Adalimumab is the first fully human, monoclonal TNF alpha antibody, which is administered subcutaneously. Since April 2012 adalimumab is approved for the treatment of moderately to severely active ulcerative colitis in patients who have not responded despite a full and adequate course of therapy with a corticosteroid and an immunosuppressant or who are intolerant to or have medical contraindications for such therapies. Adalimumab can induce and maintain clinical remission and mucosal healing compared to placebo in moderately to severely active ulcerative colitis, can reduce the rate of ulcerative colitis related hospitalisations and improve health-related quality of life. The response can be observed after two weeks of treatment. The safety profile of adalimumab is comparable to those of other TNF alpha inhibitors. Studies on the treatment of ulcerative colitis with adalimumab did not reveal new safety aspects. The present consensus report by the Working Group Inflammatory Bowel Diseases of the Austrian Society of Gastroenterology and Hepatology presents the existing evidence of adalimumab for the treatment of ulcerative colitis and is aimed to assist as code of its practice. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Advances in pediatrics in 2014: current practices and challenges in allergy, gastroenterology, infectious diseases, neonatology, nutrition, oncology and respiratory tract illnesses.

    PubMed

    Caffarelli, Carlo; Santamaria, Francesca; Cesari, Silvia; Sciorio, Elisa; Povesi-Dascola, Carlotta; Bernasconi, Sergio

    2015-10-31

    Major advances in the conduct of pediatric practice have been reported in the Italian Journal of Pediatrics in 2014. This review highlights developments in allergy, gastroenterology, infectious diseases, neonatology, nutrition, oncology and respiratory tract illnesses. Investigations endorse a need to better educate guardians and improve nutritional management in food allergy. Management of hyperbilirubinemia in neonates and of bronchiolitis have been improved by position statements of scientific societies. Novel treatments for infant colic and inflammatory bowel diseases have emerged. Studies suggest the diagnostic utility of ultrasonography in diagnosing community-acquired pneumonia. Progress in infectious diseases should include the universal varicella vaccination of children. Recommendations on asphyxia and respiratory distress syndrome have been highlighted in neonatology. Studies have evidenced that malnutrition remains a common underestimated problem in developing countries, while exposure to cancer risk factors in children is not negligible in Western countries. Advances in our understanding of less common diseases such as cystic fibrosis, plastic bronchitis, idiopathic pulmonary hemosiderosis facilitate diagnosis and management. Researches have led to new therapeutic approaches in patent ductus arteriosus and pediatric malignancies.

  11. British Society of Gastroenterology/Association of Coloproctologists of Great Britain and Ireland guidelines for the management of large non-pedunculated colorectal polyps

    PubMed Central

    Rutter, Matthew D; Chattree, Amit; Barbour, Jamie A; Thomas-Gibson, Siwan; Bhandari, Pradeep; Saunders, Brian P; Veitch, Andrew M; Anderson, John; Rembacken, Bjorn J; Loughrey, Maurice B; Pullan, Rupert; Garrett, William V; Lewis, Gethin; Dolwani, Sunil

    2015-01-01

    These guidelines provide an evidence-based framework for the management of patients with large non-pedunculated colorectal polyps (LNPCPs), in addition to identifying key performance indicators (KPIs) that permit the audit of quality outcomes. These are areas not previously covered by British Society of Gastroenterology (BSG) Guidelines. A National Institute of Health and Care Excellence (NICE) compliant BSG guideline development process was used throughout and the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to structure the guideline development process. A systematic review of literature was conducted for English language articles up to May 2014 concerning the assessment and management of LNPCPs. Quality of evaluated studies was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist System. Proposed recommendation statements were evaluated by each member of the Guideline Development Group (GDG) on a scale from 1 (strongly agree) to 5 (strongly disagree) with >80% agreement required for consensus to be reached. Where consensus was not reached a modified Delphi process was used to re-evaluate and modify proposed statements until consensus was reached or the statement discarded. A round table meeting was subsequently held to finalise recommendations and to evaluate the strength of evidence discussed. The GRADE tool was used to assess the strength of evidence and strength of recommendation for finalised statements. KPIs, a training framework and potential research questions for the management of LNPCPs were also developed. It is hoped that these guidelines will improve the assessment and management of LNPCPs. PMID:26104751

  12. NPL 1999 Annual Report

    SciTech Connect

    2000-01-01

    OAK-B135 NPL 1999 Annual Report. The Nuclear Physics Laboratory at the University of Washington in Seattle pursues a broad program of nuclear physics research. Research activities are conducted locally and at remote sites. The current program includes ''in-house'' research on nuclear collisions using the local tandem Van de Graaff and superconducting linac accelerators as well as local and remote non-accelerator research on fundamental symmetries and weak interactions and user-mode research on relativistic heavy ions at large accelerator facilities around the world.

  13. International energy annual 1995

    SciTech Connect

    1996-12-01

    The International Energy Annual presents information and trends on world energy production and consumption for petroleum, natural gas, coal, and electricity. Production and consumption data are reported in standard units as well as British thermal units (Btu). Trade and reserves are shown for petroleum, natural gas, and coal. Data are provided on crude oil refining capacity and electricity installed capacity by type. Prices are included for selected crude oils and for refined petroleum products in selected countries. Population and Gross Domestic Product data are also provided.

  14. Annual Research Briefs, 1990

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The 1990 annual progress reports of the Research Fellows and students of the Center for Turbulent Research (CTR) are included. It is intended primarily as a contractor report to NASA, Ames Research Center. In addition, numerous CTR Manuscript Reports were published last year. The purpose of the CTR Manuscript Series is to expedite the dissemination of research results by the CTR staff. The CTR is devoted to the fundamental study of turbulent flow; its objectives are to produce advances in physical understanding of turbulence, in turbulence modeling and simulation, and in turbulence control.

  15. Annual research briefs, 1989

    NASA Technical Reports Server (NTRS)

    Spinks, Debra (Compiler)

    1990-01-01

    This report contains the 1989 annual progress reports of the Research Fellows of the Center for Turbulence Research. It is intended as a year end report to NASA, Ames Research Center which supports this group through core funding and by making available physical and intellectual resources. The Center for Turbulence Research is devoted to the fundamental study of turbulent flows; its objectives are to simulate advances in the physical understanding of turbulence, in turbulence modeling and simulation, and in turbulence control. The reports appearing in the following pages are grouped in the general areas of modeling, experimental research, theory, simulation and numerical methods, and compressible and reacting flows.

  16. Annual Energy Review 2010

    SciTech Connect

    2011-10-01

    This twenty-ninth edition of the Annual Energy Review (AER) presents the U.S. Energy Information Administration’s (EIA) most comprehensive look at integrated energy statistics. The summary statistics on the Nation’s energy production, consumption, trade, stocks, and prices cover all major energy commodities and all energy-consuming sectors of the U.S. economy from 1949 through 2010. The AER is EIA’s historical record of energy statistics and, because the coverage spans six decades, the statistics in this report are well-suited to long-term trend analysis.

  17. Annual Energy Review 2001

    SciTech Connect

    Seiferlein, Katherine E.

    2002-11-01

    The Annual Energy Review (AER) is a statistical history of energy activities in the United States. It documents trends and milestones in U.S. energy production, trade, storage, pricing, and consumption. Each new year of data that is added to the time series—which now reach into 7 decades—extends the story of how Americans have acquired and used energy. It is a story of continual change as the Nation's economy grew, energy requirements expanded, resource availability shifted, and interdependencies developed among nations.

  18. Annual report to Congress

    SciTech Connect

    1992-03-01

    This is the eighth annual report submitted by the Office of Civilian Radioactive Waste Management (OCRWM) to Congress. It covers activities and expenditures during Fiscal Year 1991, which ended September 30, 1991. Chapter 1 of this report describes OCRWM`s mission and objectives. Chapters 2 through 8 cover the following topics: earning public trust and confidence; geological disposal; monitored retrieval storage; transportation; systems integration and regulatory compliance; international programs; and program management. Financial statements for the Nuclear Waste Fund are presented in Chapter 9.

  19. Ultrasound Annual, 1983

    SciTech Connect

    Sanders, R.C.; Hill, M.C.

    1983-01-01

    The 1983 edition of Ultrasound Annual features a state-of-the-art assessment of real-time ultrasound technology and a look at improvements in real-time equipment. Chapters discuss important new obstetric applications of ultrasound in measuring fetal umbilical vein blood flow and monitoring ovarian follicular development in vivo and in vitro fertilization. Other topics covered include transrectal prostate ultrasound using a linear array system; ultrasound of the common bile duct; ultrasound in tropical diseases; prenatal diagnosis of craniospinal anomalies; scrotal ultrasonography; opthalmic ultrasonography; and sonography of the upper abdominal venous system.

  20. Nuclear medicine annual, 1987

    SciTech Connect

    Freeman, L.M.; Weissmann, H.S.

    1987-01-01

    Radionuclide evaluation of brain death, bone imaging with SPECT, and lymphoscintigraphy are among the topics covered in Nuclear Medicine Annual, 1987. In addition, the book includes reviews of the role of nuclear medicine in the diagnosis of the Acquired Immunodeficiency Syndrome (AIDS) and in the management of patients with acute myocardial infarction. Reports describe advances in radionuclide and magnetic resonance imaging of the adrenal gland and assess the current status of diuretic renography. Also included are articles on changes in functional imaging with aging, on radionuclide evaluation of the lower genitourinary tract in children, and on cholescintigraphy in children.

  1. Renewable energy annual 1996

    SciTech Connect

    1997-03-01

    This report presents summary data on renewable energy consumption, the status of each of the primary renewable technologies, a profile of each of the associated industries, an analysis of topical issues related to renewable energy, and information on renewable energy projects worldwide. It is the second in a series of annual reports on renewable energy. The renewable energy resources included in the report are biomass (wood and ethanol); municipal solid waste, including waste-to-energy and landfill gas; geothermal; wind; and solar energy, including solar thermal and photovoltaic. The report also includes various appendices and a glossary.

  2. Annual Progress Report.

    DTIC Science & Technology

    1981-10-20

    AD-AIO6 983 ILLINOIS UNIV AT URBANA COORDINATEO SCIENCE LAB F/0 12/1 ANNUAL PROGRESS REPOMT ,(U1 OCT 81 H V POOR NOOOII-81-K-O014 UNCLASSIFIED T-111...34 University of Illinois at Urbana -Chaimpaign Urbana , Illinois 61801 I ~~ ~ ~ ~ I I7 CONROLINOFIC______NDADDES Office of Naval Research - Octe--mm...Unclassified Approved for public release; dis tribu tion ’anlimi ted. 17. DISTRIBUTION STATEMENT (of the aboeet onfored a Weak 20. 1# Offrmoaw Repeol

  3. Nuclear Medicine Annual, 1989

    SciTech Connect

    Freeman, L.M.; Weissmann, H.S.

    1989-01-01

    Among the highlights of Nuclear Medicine Annual, 1989 are a status report on the thyroid scan in clinical practice, a review of functional and structural brain imaging in dementia, an update on radionuclide renal imaging in children, and an article outlining a quality assurance program for SPECT instrumentation. Also included are discussions on current concepts in osseous sports and stress injury scintigraphy and on correlative magnetic resonance and radionuclide imaging of bone. Other contributors assess the role of nuclear medicine in clinical decision making and examine medicolegal and regulatory aspects of nuclear medicine.

  4. Annual Research Briefs - 2006

    DTIC Science & Technology

    2006-12-01

    a round liq- uid jet by a coaxial flow of gas. D. KIM, 0. DESJARDINS, MI. HERRMANN AND P. MOIN 185 Stable and high-order accurate finite difference...Research 185 Annual Research Briefs 2006 Toward two-phase simulation of the primary breakup of a round liquid jet by a coaxial flow of gas By D. Kim, 0...gas phase. The flow solver volume fraction i) is defined as The breakup of a round liquid jet by a coaxial flow of gas 187 Vi = ’ H(G)dV, (2.9) where

  5. Annual Energy Review 2004

    SciTech Connect

    Seiferlein, Katherine E.

    2005-08-01

    The Annual Energy Review (AER) is the Energy Information Administration's (EIA) primary report of annual historical energy statistics. For many series, data begin with the year 1949. Included are data on total energy production, consumption, and trade; overviews of petroleum, natural gas, coal, electricity, nuclear energy, renewable energy, international energy, as well as financial and environment indicators; and data unit conversion tables. Publication of this report is required under Public Law 95–91 (Department of Energy Organization Act), Section 205(c), and is in keeping with responsibilities given to the EIA under Section 205(a)(2), which states: “The Administrator shall be responsible for carrying out a central, comprehensive, and unified energy data and information program which will collect, evaluate, assemble, analyze, and disseminate data and information....” The AER is intended for use by Members of Congress, Federal and State agencies energy analysts, and the general public. EIA welcomes suggestions from readers regarding data series in the AER and in other EIA publications.

  6. Annual Energy Review 2011

    SciTech Connect

    Fichman, Barbara T.

    2012-09-01

    The Annual Energy Review (AER) is the U.S. Energy Information Administration's (EIA) primary report of annual historical energy statistics. For many series, data begin with the year 1949. Included are statistics on total energy production, consumption, trade, and energy prices; overviews of petroleum, natural gas, coal, electricity, nuclear energy, and renewable energy; financial and environment indicators; and data unit conversions. Publication of this report is required under Public Law 95–91 (Department of Energy Organization Act), Section 205(c), and is in keeping with responsibilities given to the EIA under Section 205(a)(2), which states: “The Administrator shall be responsible for carrying out a central, comprehensive, and unified energy data and information program which will collect, evaluate, assemble, analyze, and disseminate data and information....” The AER is intended for use by Members of Congress, Federal and State agencies, energy analysts, and the general public. EIA welcomes suggestions from readers regarding the content of the AER and other EIA publications.

  7. Annual Energy Review 1993

    SciTech Connect

    Not Available

    1994-07-14

    This twelfth edition of the Annual Energy Review (AER) presents the Energy Information Administration`s historical energy statistics. For most series, statistics are given for every year from 1949 through 1993. Because coverage spans four and a half decades, the statistics in this report are well-suited to long-term trend analyses. The AER is comprehensive. It covers all major energy activities, including consumption, production, trade, stocks, and prices, for all major energy commodities, including fossil fuels and electricity. The AER also presents Energy Information Administration (EIA) statistics on some renewable energy sources. EIA estimates that its consumption series include about half of the renewable energy used in the United States. For a more complete discussion of EIA`s renewables data, see p. xix, ``Introducing Expanded Coverage of Renewable Energy Data Into the Historical Consumption Series.`` Copies of the 1993 edition of the Annual Energy Review may be obtained by using the order form in the back of this publication. Most of the data in the 1993 edition also are available on personal computer diskette. For more information about the diskettes, see the back of this publication. In addition, the data are available as part of the National Economic, Social, and Environmental Data Bank on a CD-ROM. For more information about the data bank, contact the US Department of Commerce Economics and Statistics Administration, on 202-482-1986.

  8. Annual Energy Review 2006

    SciTech Connect

    Seiferlein, Katherine E.

    2007-06-01

    The Annual Energy Review (AER) is the Energy Information Administration's (EIA) primary report of annual historical energy statistics. For many series, data begin with the year 1949. Included are data on total energy production, consumption, and trade; overviews of petroleum, natural gas, coal, electricity, nuclear energy, renewable energy, international energy, as well as financial and environment indicators; and data unit conversion tables. Publication of this report is required under Public Law 95–91 (Department of Energy Organization Act), Section 205(c), and is in keeping with responsibilities given to the EIA under Section 205(a)(2), which states: “The Administrator shall be responsible for carrying out a central, comprehensive, and unified energy data and information program which will collect, evaluate, assemble, analyze, and disseminate data and information....” The AER is intended for use by Members of Congress, Federal and State agencies, energy analysts, and the general public. EIA welcomes suggestions from readers regarding data series in the AER and in other EIA publications.

  9. Annual Energy Review 2005

    SciTech Connect

    Seiferlein, Katherine E.

    2006-07-01

    The Annual Energy Review (AER) is the Energy Information Administration's (EIA) primary report of annual historical energy statistics. For many series, data begin with the year 1949. Included are data on total energy production, consumption, and trade; overviews of petroleum, natural gas, coal, electricity, nuclear energy, renewable energy, international energy, as well as financial and environment indicators; and data unit conversion tables. Publication of this report is required under Public Law 95–91 (Department of Energy Organization Act), Section 205(c), and is in keeping with responsibilities given to the EIA under Section 205(a)(2), which states: “The Administrator shall be responsible for carrying out a central, comprehensive, and unified energy data and information program which will collect, evaluate, assemble, analyze, and disseminate data and information....” The AER is intended for use by Members of Congress, Federal and State agencies, energy analysts, and the general public. EIA welcomes suggestions from readers regarding data series in the AER and in other EIA publications.

  10. Annual Energy Review 2009

    SciTech Connect

    Fichman, Barbara T.

    2010-08-01

    The Annual Energy Review (AER) is the U.S. Energy Information Administration's (EIA) primary report of annual historical energy statistics. For many series, data begin with the year 1949. Included are statistics on total energy production, consumption, trade, and energy prices; overviews of petroleum, natural gas, coal, electricity, nuclear energy, renewable energy, and international energy; financial and environment indicators; and data unit conversions. Publication of this report is required under Public Law 95–91 (Department of Energy Organization Act), Section 205(c), and is in keeping with responsibilities given to the EIA under Section 205(a)(2), which states: “The Administrator shall be responsible for carrying out a central, comprehensive, and unified energy data and information program which will collect, evaluate, assemble, analyze, and disseminate data and information....” The AER is intended for use by Members of Congress, Federal and State agencies, energy analysts, and the general public. EIA welcomes suggestions from readers regarding the content of the AER and other EIA publications.

  11. Electric power annual 1992

    SciTech Connect

    Not Available

    1994-01-06

    The Electric Power Annual presents a summary of electric utility statistics at national, regional and State levels. The objective of the publication is to provide industry decisionmakers, government policymakers, analysts and the general public with historical data that may be used in understanding US electricity markets. The Electric Power Annual is prepared by the Survey Management Division; Office of Coal, Nuclear, Electric and Alternate Fuels; Energy Information Administration (EIA); US Department of Energy. ``The US Electric Power Industry at a Glance`` section presents a profile of the electric power industry ownership and performance, and a review of key statistics for the year. Subsequent sections present data on generating capability, including proposed capability additions; net generation; fossil-fuel statistics; retail sales; revenue; financial statistics; environmental statistics; electric power transactions; demand-side management; and nonutility power producers. In addition, the appendices provide supplemental data on major disturbances and unusual occurrences in US electricity power systems. Each section contains related text and tables and refers the reader to the appropriate publication that contains more detailed data on the subject matter. Monetary values in this publication are expressed in nominal terms.

  12. CMS Annual Report 2004

    SciTech Connect

    de la Rubia, T D; Shang, S P; Rennie, G; Fluss, M; Westbrook, C

    2005-07-29

    Glance at the articles in this report, and you will sense the transformation that is reshaping the landscape of materials science and chemistry. This transformation is bridging the gaps among chemistry, materials science, and biology--ushering in a wealth of innovative technologies with broad scientific impact. The emergence of this intersection is reinvigorating our strategic investment into areas that build on our strength of interdisciplinary science. It is at the intersection that we position our strategic vision into a future where we will provide radical materials innovations and solutions to our national-security programs and other sponsors. Our 2004 Annual Report describes how our successes and breakthroughs follow a path set forward by our strategic plan and four organizing research themes, each with key scientific accomplishments by our staff and collaborators. We have organized this report into two major sections: research themes and our dynamic teams. The research-theme sections focus on achievements arising from earlier investments while addressing future challenges. The dynamic teams section illustrates the directorate's organizational structure of divisions, centers, and institutes that support a team environment across disciplinary and institutional boundaries. The research presented in this annual report gives substantive examples of how we are proceeding in each of these four theme areas and how they are aligned with our national-security mission. By maintaining an organizational structure that offers an environment of collaborative problem-solving opportunities, we are able to nurture the discoveries and breakthroughs required for future successes.

  13. Annual Energy Review 1999

    SciTech Connect

    Seiferlein, Katherine E.

    2000-07-01

    A generation ago the Ford Foundation convened a group of experts to explore and assess the Nation’s energy future, and published their conclusions in A Time To Choose: America’s Energy Future (Cambridge, MA: Ballinger, 1974). The Energy Policy Project developed scenarios of U.S. potential energy use in 1985 and 2000. Now, with 1985 well behind us and 2000 nearly on the record books, it may be of interest to take a look back to see what actually happened and consider what it means for our future. The study group sketched three primary scenarios with differing assumptions about the growth of energy use. The Historical Growth scenario assumed that U.S. energy consumption would continue to expand by 3.4 percent per year, the average rate from 1950 to 1970. This scenario assumed no intentional efforts to change the pattern of consumption, only efforts to encourage development of our energy supply. The Technical Fix scenario anticipated a “conscious national effort to use energy more efficiently through engineering know-how." The Zero Energy Growth scenario, while not clamping down on the economy or calling for austerity, incorporated the Technical Fix efficiencies plus additional efficiencies. This third path anticipated that economic growth would depend less on energy-intensive industries and more on those that require less energy, i.e., the service sector. In 2000, total energy consumption was projected to be 187 quadrillion British thermal units (Btu) in the Historical Growth case, 124 quadrillion Btu in the Technical Fix case, and 100 quadrillion Btu in the Zero Energy Growth case. The Annual Energy Review 1999 reports a preliminary total consumption for 1999 of 97 quadrillion Btu (see Table 1.1), and the Energy Information Administration’s Short-Term Energy Outlook (April 2000) forecasts total energy consumption of 98 quadrillion Btu in 2000. What energy consumption path did the United States actually travel to get from 1974, when the scenarios were drawn

  14. The health economic impact of upper gastrointestinal symptoms in the general population: results from the Domestic/International Gastroenterology Surveillance Study (DIGEST).

    PubMed

    Haycox, A; Einarson, T; Eggleston, A

    1999-01-01

    The Domestic/International Gastroenterology Surveillance Study (DIGEST) is the first large, multinational, population-based survey to assess the 3-month prevalence and economic/quality-of-life impact of upper gastrointestinal symptoms (UGIS). A total of 5581 subjects were interviewed in 10 countries (grouped into seven regions). Respondents were classified as having relevant or non-relevant upper gastrointestinal symptoms, and questioned about consumption of healthcare resources in terms of doctor consultations, prescribed and non-prescribed medications, hospital stays and investigations for both gastrointestinal and other health problems. The impact of symptoms in terms of time lost and reduced effectiveness at work or social activities was also recorded. Twenty-eight percent of the total sample was defined as having clinically relevant UGIS (UGIS of at least moderate severity and with a frequency of at least once per week in the previous 3 months). During the period studied, 20% of these subjects had consulted a family practitioner (16.2%) and/ or a specialist (6.3%), primarily for UGIS. Of those with clinically relevant UGIS, 49% had taken over-the-counter medication, and 27% prescription medication for gastrointestinal (GI) symptoms. Two percent reported a hospital stay and 27% reported days of reduced or no work, school or domestic productivity due to UGIS. Four percent of all study subjects underwent investigations for UGIS during this period. Variations between countries in these parameters may be due to differences in healthcare systems and cultural attitudes towards UGIS, influencing both the healthcare-seeking behaviour of subjects with UGIS and their management.

  15. Canadian Association of Gastroenterology Clinical Practice Guidelines: The use of tumour necrosis factor-alpha antagonist therapy in Crohn’s disease

    PubMed Central

    Sadowski, Daniel C; Bernstein, Charles N; Bitton, Alain; Croitoru, Ken; Fedorak, Richard N; Griffiths, Anne

    2009-01-01

    BACKGROUND: Guidelines regarding the use of infliximab in Crohn’s disease were previously published by the Canadian Association of Gastroenterology in 2004. However, recent clinical findings and drug developments warrant a review and update of these guidelines. OBJECTIVE: To review and update Canadian guidelines regarding the use of tumour necrosis factor-alpha antibody therapy in both luminal and fistulizing Crohn’s disease. METHODS: A consensus group of 25 voting participants developed a series of recommendation statements that addressed pertinent clinical questions and gaps in existing knowledge. An iterative voting and feedback process was used in advance of the consensus meeting in conjunction with a systematic literature review to refine the voting statements. These statements were brought to a formal consensus meeting held in Montreal, Quebec (March 2008), wherein each statement underwent discussion, reformulation, voting and subsequent revision until group consensus was obtained (at least 80% agreement). OUTCOME: The 47 voting statements addressed three themes: induction therapy, maintenance therapy and safety issues. As a result of the iterative process, 23 statements achieved consensus and were submitted for publication. CONCLUSION: In the past five years, tumour necrosis factor-alpha antagonist therapy has become a cornerstone in the management of moderate-to-severe Crohn’s disease refractory to conventional treatment algorithms. The evidentiary base supporting the use of these drugs in Crohn’s disease is substantial and strengthened by results from long-term clinical and molecular studies. However, significant gaps in knowledge exist, particularly with regard to treatment failure. Confidence in the safety of these drugs is increasing, provided that therapy is administered in a clinical setting in which potential complications can be readily recognized and treated. PMID:19319383

  16. Gluten Introduction and the Risk of Coeliac Disease: A Position Paper by the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

    PubMed

    Szajewska, Hania; Shamir, Raanan; Mearin, Luisa; Ribes-Koninckx, Carmen; Catassi, Carlo; Domellöf, Magnus; Fewtrell, Mary S; Husby, Steffen; Papadopoulou, Alexandra; Vandenplas, Yvan; Castillejo, Gemma; Kolacek, Sanja; Koletzko, Sibylle; Korponay-Szabó, Ilma R; Lionetti, Elena; Polanco, Isabel; Troncone, Riccardo

    2016-03-01

    The European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommended in 2008, based on observational data, to avoid both early (<4 months) and late (≥7 months) introduction of gluten and to introduce gluten while the infant is still being breast-fed. New evidence prompted ESPGHAN to revise these recommendations. To provide updated recommendations regarding gluten introduction in infants and the risk of developing coeliac disease (CD) during childhood. The risk of inducing CD through a gluten-containing diet exclusively applies to persons carrying at least one of the CD risk alleles. Because genetic risk alleles are generally not known in an infant at the time of solid food introduction, the following recommendations apply to all infants, although they are derived from studying families with first-degree relatives with CD. Although breast-feeding should be promoted for its other well-established health benefits, neither any breast-feeding nor breast-feeding during gluten introduction has been shown to reduce the risk of CD. Gluten may be introduced into the infant's diet anytime between 4 and 12 completed months of age. In children at high risk for CD, earlier introduction of gluten (4 vs 6 months or 6 vs 12 months) is associated with earlier development of CD autoimmunity (defined as positive serology) and CD, but the cumulative incidence of each in later childhood is similar. Based on observational data pointing to the association between the amount of gluten intake and risk of CD, consumption of large quantities of gluten should be avoided during the first weeks after gluten introduction and during infancy. The optimal amounts of gluten to be introduced at weaning, however, have not been established.

  17. American Gastroenterological Association guidelines are inaccurate in detecting pancreatic cysts with advanced neoplasia: a clinicopathologic study of 225 patients with supporting molecular data.

    PubMed

    Singhi, Aatur D; Zeh, Herbert J; Brand, Randall E; Nikiforova, Marina N; Chennat, Jennifer S; Fasanella, Kenneth E; Khalid, Asif; Papachristou, Georgios I; Slivka, Adam; Hogg, Melissa; Lee, Kenneth K; Tsung, Allan; Zureikat, Amer H; McGrath, Kevin

    2016-06-01

    The American Gastroenterological Association (AGA) recently reported evidence-based guidelines for the management of asymptomatic neoplastic pancreatic cysts. These guidelines advocate a higher threshold for surgical resection than prior guidelines and imaging surveillance for a considerable number of patients with pancreatic cysts. The aims of this study were to assess the accuracy of the AGA guidelines in detecting advanced neoplasia and present an alternative approach to pancreatic cysts. The study population consisted of 225 patients who underwent EUS-guided FNA for pancreatic cysts between January 2014 and May 2015. For each patient, clinical findings, EUS features, cytopathology results, carcinoembryonic antigen analysis, and molecular testing of pancreatic cyst fluid were reviewed. Molecular testing included the assessment of hotspot mutations and deletions for KRAS, GNAS, VHL, TP53, PIK3CA, and PTEN. Diagnostic pathology results were available for 41 patients (18%), with 13 (6%) harboring advanced neoplasia. Among these cases, the AGA guidelines identified advanced neoplasia with 62% sensitivity, 79% specificity, 57% positive predictive value, and 82% negative predictive value. Moreover, the AGA guidelines missed 45% of intraductal papillary mucinous neoplasms with adenocarcinoma or high-grade dysplasia. For cases without confirmatory pathology, 27 of 184 patients (15%) with serous cystadenomas (SCAs) based on EUS findings and/or VHL alterations would continue magnetic resonance imaging (MRI) surveillance. In comparison, a novel algorithmic pathway using molecular testing of pancreatic cyst fluid detected advanced neoplasias with 100% sensitivity, 90% specificity, 79% positive predictive value, and 100% negative predictive value. The AGA guidelines were inaccurate in detecting pancreatic cysts with advanced neoplasia. Furthermore, because the AGA guidelines manage all neoplastic cysts similarly, patients with SCAs will continue to undergo unnecessary MRI

  18. Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants: British Society of Gastroenterology (BSG) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines

    PubMed Central

    Veitch, Andrew M; Vanbiervliet, Geoffroy; Gershlick, Anthony H; Boustiere, Christian; Baglin, Trevor P; Smith, Lesley-Ann; Radaelli, Franco; Knight, Evelyn; Gralnek, Ian M; Hassan, Cesare; Dumonceau, Jean-Marc

    2016-01-01

    The risk of endoscopy in patients on antithrombotics depends on the risks of procedural haemorrhage versus thrombosis due to discontinuation of therapy. P2Y12 receptor antagonists (clopidogrel, prasugrel, ticagrelor) For low-risk endoscopic procedures we recommend continuing P2Y12 receptor antagonists as single or dual antiplatelet therapy (low quality evidence, strong recommendation); For high-risk endoscopic procedures in patients at low thrombotic risk, we recommend discontinuing P2Y12 receptor antagonists five days before the procedure (moderate quality evidence, strong recommendation). In patients on dual antiplatelet therapy, we suggest continuing aspirin (low quality evidence, weak recommendation). For high-risk endoscopic procedures in patients at high thrombotic risk, we recommend continuing aspirin and liaising with a cardiologist about the risk/benefit of discontinuation of P2Y12 receptor antagonists (high quality evidence, strong recommendation). Warfarin The advice for warfarin is fundamentally unchanged from British Society of Gastroenterology (BSG) 2008 guidance. Direct Oral Anticoagulants (DOAC) For low-risk endoscopic procedures we suggest omitting the morning dose of DOAC on the day of the procedure (very low quality evidence, weak recommendation); For high-risk endoscopic procedures, we recommend that the last dose of DOAC be taken ≥48 h before the procedure (very low quality evidence, strong recommendation). For patients on dabigatran with CrCl (or estimated glomerular filtration rate, eGFR) of 30–50 mL/min we recommend that the last dose of DOAC be taken 72 h before the procedure (very low quality evidence, strong recommendation). In any patient with rapidly deteriorating renal function a haematologist should be consulted (low quality evidence, strong recommendation). PMID:26873868

  19. Clinical management of esophagogastroduodenoscopy by clinicians under the former guidelines of the Japan Gastroenterological Endoscopy Society for patients taking anticoagulant and antiplatelet medications.

    PubMed

    Iwatsuka, Kunio; Gotoda, Takuji; Kusano, Chika; Fukuzawa, Masakatsu; Sugimoto, Katsutoshi; Itoi, Takao; Kawai, Takashi; Moriyasu, Fuminori

    2014-10-01

    The 2005 Japan Gastroenterological Endoscopy Society (JGES) guidelines for the management of antithrombotic drugs focused on the increasing risks of bleeding, even from biopsy during scheduled esophagogastroduodenoscopy (EGD). The new 2012 guidelines emphasized the prevention of thromboembolic complications. To compare with the new guidelines, we investigated the clinical management of EGD by clinicians under the former JGES guidelines for patients taking antithrombotic agents. Medical records of 4574 patients (mean age 63.4 years, range 3-96 years, male/female ratio 2805/1769) who underwent scheduled EGD from April 2011 to March 2012 were reviewed retrospectively. The prescribed agents, pre-existing comorbidities, drug cessation before EGD, bleeding, and thromboembolic complications were investigated. Five hundred forty-six patients (12.0 %) were taking antithrombotic drugs (aspirin, 313; warfarin, 134; cilostazol, 57; clopidogrel, 59; ethylicosapentate, 40; prostaglandin preparations, 41; ticlopidine, 29; icosapentate, 24; dipyridamole, 4); 116 and 29 patients, respectively, were managed with a combination of 2 or 3 agents. Among 490 patients whose medical records were precisely documented, 40.6 % underwent EGD without cessation. Bleeding and thromboembolic complications were not observed. The most common pre-existing comorbidity was ischemic heart disease (27.9 %), followed by carotid or intracranial large artery atherosclerosis (20.5 %), cerebral infarction or transient ischemic attack (20.3 %), and atrial fibrillation (15.9 %). Patients with pre-existing comorbidity requiring anticoagulants frequently underwent EGD without cessation. We revealed the low impact of the 2005 JGES guidelines on the management of antithrombotic drugs. Our physicians have reasonably decided to continue antithrombotic drugs before EGD according to the risk of thromboembolism.

  20. Annual Research Briefs, 1992

    NASA Technical Reports Server (NTRS)

    Spinks, Debra (Compiler)

    1993-01-01

    This report contains the 1992 annual progress reports of the Research Fellows and students of the Center for Turbulence Research. Considerable effort was focused on the large eddy simulation technique for computing turbulent flows. This increased activity has been inspired by the recent predictive successes of the dynamic subgrid scale modeling procedure which was introduced during the 1990 Summer Program. Several Research Fellows and students are presently engaged in both the development of subgrid scale models and their applications to complex flows. The first group of papers in this report contain the findings of these studies. They are followed by reports grouped in the general areas of modeling, turbulence physics, and turbulent reacting flows. The last contribution in this report outlines the progress made on the development of the CTR post-processing facility.

  1. Petroleum marketing annual 1993

    SciTech Connect

    Not Available

    1995-01-01

    The Petroleum Marketing Annual (PMA) contains statistical data on a variety of crude oils and refined petroleum products. The publication provides statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysts, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the free-on-board (f.o.b.) and landed cost of imported crude oil, and the refiners acquisition cost of crude oil. Sales data for motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane are presented. For this publication, all estimates have been recalculated since their earlier publication in the Petroleum Marketing Monthly (PMM). These calculations made use of additional data and corrections that were received after the PMM publication dates.

  2. Annual energy review 1994

    NASA Astrophysics Data System (ADS)

    1995-07-01

    This 13th edition presents the Energy Information Administration's historical energy statistics. For most series, statistics are given for every year from 1949 through 1994; thus, this report is well-suited to long-term trend analyses. It covers all major energy activities, including consumption, production, trade, stocks, and prices for all major energy commodities, including fossil fuels and electricity. Statistics on renewable energy sources are also included: this year, for the first time, usage of renewables by other consumers as well as by electric utilities is included. Also new is a two-part, comprehensive presentation of data on petroleum products supplied by sector for 1949 through 1994. Data from electric utilities and nonutilities are integrated as 'electric power industry' data; nonutility power gross generation are presented for the first time. One section presents international statistics (for more detail see EIA's International Energy Annual).

  3. Annual energy review 1994

    SciTech Connect

    1995-07-01

    This 13th edition presents the Energy Information Administration`s historical energy statistics. For most series, statistics are given for every year from 1949 through 1994; thus, this report is well-suited to long-term trend analyses. It covers all major energy activities, including consumption, production, trade, stocks, and prices for all major energy commodities, including fossil fuels and electricity. Statistics on renewable energy sources are also included: this year, for the first time, usage of renewables by other consumers as well as by electric utilities is included. Also new is a two-part, comprehensive presentation of data on petroleum products supplied by sector for 1949 through 1994. Data from electric utilities and nonutilities are integrated as ``electric power industry`` data; nonutility power gross generation are presented for the first time. One section presents international statistics (for more detail see EIA`s International Energy Annual).

  4. Uranium industry annual 1996

    SciTech Connect

    1997-04-01

    The Uranium Industry Annual 1996 (UIA 1996) provides current statistical data on the US uranium industry`s activities relating to uranium raw materials and uranium marketing. The UIA 1996 is prepared for use by the Congress, Federal and State agencies, the uranium and nuclear electric utility industries, and the public. Data on uranium raw materials activities for 1987 through 1996 including exploration activities and expenditures, EIA-estimated reserves, mine production of uranium, production of uranium concentrate, and industry employment are presented in Chapter 1. Data on uranium marketing activities for 1994 through 2006, including purchases of uranium and enrichment services, enrichment feed deliveries, uranium fuel assemblies, filled and unfilled market requirements, uranium imports and exports, and uranium inventories are shown in Chapter 2. A feature article, The Role of Thorium in Nuclear Energy, is included. 24 figs., 56 tabs.

  5. Uranium Industry Annual, 1992

    SciTech Connect

    Not Available

    1993-10-28

    The Uranium Industry Annual provides current statistical data on the US uranium industry for the Congress, Federal and State agencies, the uranium and electric utility industries, and the public. The feature article, ``Decommissioning of US Conventional Uranium Production Centers,`` is included. Data on uranium raw materials activities including exploration activities and expenditures, resources and reserves, mine production of uranium, production of uranium concentrate, and industry employment are presented in Chapter 1. Data on uranium marketing activities including domestic uranium purchases, commitments by utilities, procurement arrangements, uranium imports under purchase contracts and exports, deliveries to enrichment suppliers, inventories, secondary market activities, utility market requirements, and uranium for sale by domestic suppliers are presented in Chapter 2.

  6. Coal industry annual 1993

    SciTech Connect

    Not Available

    1994-12-06

    Coal Industry Annual 1993 replaces the publication Coal Production (DOE/FIA-0125). This report presents additional tables and expanded versions of tables previously presented in Coal Production, including production, number of mines, Productivity, employment, productive capacity, and recoverable reserves. This report also presents data on coal consumption, coal distribution, coal stocks, coal prices, coal quality, and emissions for a wide audience including the Congress, Federal and State agencies, the coal industry, and the general public. In addition, Appendix A contains a compilation of coal statistics for the major coal-producing States. This report does not include coal consumption data for nonutility Power Producers who are not in the manufacturing, agriculture, mining, construction, or commercial sectors. This consumption is estimated to be 5 million short tons in 1993.

  7. 1994 MCAP annual report

    SciTech Connect

    Harmony, S.C.; Boyack, B.E.

    1995-04-01

    VELCOR is an integrated, engineering-level computer code that models the progression of severe accidents in light water reactor (LWR) nuclear power plants. The entire spectrum of severe accident phenomena, including reactor coolant system and containment thermal-hydraulic response, core heatup, degradation and relocation, and fission product release and transport is treated in MELCOR in a unified framework for both boiling water reactors (BWRs) and pressurized water reactors (PWRs). Its current uses include the estimation of severe accident source terms and their sensitivities and uncertainties in a variety of applications. Independent assessment efforts have been successfully completed by the US and international MELCOR user communities. Most of these independent assessment efforts have been conducted to support the needs and fulfill the requirements of the individual user organizations. The resources required to perform an extensive set of model and integral code assessments are large. A prudent approach to fostering code development and maturation is to coordinate the individual assessment efforts of the MELCOR user community. While retaining individual control over assessment resources, each organization using the MELCOR code could work with the other users to broaden assessment coverage and minimize duplication. In recognition of these considerations, the US Nuclear Regulatory Commission (US NRC) has initiated the MELCOR Cooperative Assessment Program (MCAP), a vehicle for coordinating and standardizing the assessment practices of the various MELCOR users. In addition, the user community will have a forum to better communicate lessons learned regarding MELCOR applications, capabilities, and user guidelines and limitations and to provide a user community perspective on code development needs and priorities. This second Annual Report builds on the foundation laid with the first Annual Report.

  8. Annual Energy Outlook Retrospective Review

    EIA Publications

    2015-01-01

    The Annual Energy Outlook Retrospective Review provides a yearly comparison between realized energy outcomes and the Reference case projections included in previous Annual Energy Outlooks (AEO) beginning with 1982. This edition of the report adds the AEO 2012 projections and updates the historical data to incorporate the latest data revisions.

  9. Annual Reports. SPEC Kit 49.

    ERIC Educational Resources Information Center

    Association of Research Libraries, Washington, DC. Office of Management Studies.

    An examination of the Systems and Procedures Exchange Center's (SPEC) file of 72 annual reports from Association of Research Libraries (ARL) member institutions found that administrators were using annual reports for several purposes: as communication links with library users, the university administration, and the general university community,…

  10. Annual Energy Outlook Retrospective Review

    EIA Publications

    2015-01-01

    The Annual Energy Outlook Retrospective Review provides a yearly comparison between realized energy outcomes and the Reference case projections included in previous Annual Energy Outlooks (AEO) beginning with 1982. This edition of the report adds the AEO 2012 projections and updates the historical data to incorporate the latest data revisions.

  11. 2005 Annual Merit Review Proceedings

    SciTech Connect

    2009-01-18

    Each year hydrogen and fuel cell projects funded by DOE's Hydrogen Program are reviewed for their merit during an Annual Merit Review and Peer Evaluation Meeting. The 2005 Annual Merit Review was held May 23-25, 2005 in Arlington, VA

  12. The SAFE-T assessment tool: derivation and validation of a web-based application for point-of-care evaluation of gastroenterology fellow performance in colonoscopy.

    PubMed

    Kumar, Navin L; Kugener, Guillaume; Perencevich, Molly L; Saltzman, John R

    2017-05-10

    Attending assessment is a critical part of endoscopic education for gastroenterology fellows. The aim of this study was to develop and validate a concise assessment tool to evaluate real-time fellow performance in colonoscopy administered via a web-based application. The Skill Assessment in Fellow Endoscopy Training (SAFE-T) tool was derived as a novel 5-question evaluation tool that captures both summative and formative feedback adapted into a web-based application. A prospective study of 15 gastroenterology fellows (5 fellows each from years 1 to 3 of training) was performed using the SAFE-T tool. An independent reviewer evaluated a subset of these procedures and completed the SAFE-T tool and Mayo Colonoscopy Skills Assessment Tool (MCSAT) for reliability testing. Twenty-six faculty completed 350 SAFE-T evaluations of the 15 fellows in the study. The mean SAFE-T overall score (year 1, 2.00; year 2, 3.84; year 3, 4.28) differentiated each sequential fellow year of training (P < .0001). The mean SAFE-T overall score decreased with increasing case complexity score, with straightforward cases compared with average cases (4.07 vs 3.50, P < .0001), and average cases compared with challenging cases (3.50 vs 3.08, P = .0134). In dual-observed procedures, the SAFE-T tool showed excellent inter-rater reliability with a kappa agreement statistic of 0.898 (P < .0001). Correlation of the SAFE-T overall score with the MCSAT overall hands-on and individual motor scores was excellent (each r > 0.90, P < .0001). We developed and validated the SAFE-T assessment tool, a concise and web-based means of assessing real-time gastroenterology fellow performance in colonoscopy. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  13. Annual Research Briefs: 1995

    NASA Technical Reports Server (NTRS)

    1995-01-01

    This report contains the 1995 annual progress reports of the Research Fellows and students of the Center for Turbulence Research (CTR). In 1995 CTR continued its concentration on the development and application of large-eddy simulation to complex flows, development of novel modeling concepts for engineering computations in the Reynolds averaged framework, and turbulent combustion. In large-eddy simulation, a number of numerical and experimental issues have surfaced which are being addressed. The first group of reports in this volume are on large-eddy simulation. A key finding in this area was the revelation of possibly significant numerical errors that may overwhelm the effects of the subgrid-scale model. We also commissioned a new experiment to support the LES validation studies. The remaining articles in this report are concerned with Reynolds averaged modeling, studies of turbulence physics and flow generated sound, combustion, and simulation techniques. Fundamental studies of turbulent combustion using direct numerical simulations which started at CTR will continue to be emphasized. These studies and their counterparts carried out during the summer programs have had a noticeable impact on combustion research world wide.

  14. 2014 HPC Annual Report

    SciTech Connect

    Jennings, Barbara

    2014-10-01

    Our commitment is to support you through delivery of an IT environment that provides mission value by transforming the way you use, protect, and access information. We approach this through technical innovation, risk management, and relationships with our workforce, Laboratories leadership, and policy makers nationwide. This second edition of our HPC Annual Report continues our commitment to communicate the details and impact of Sandia’s large-scale computing resources that support the programs associated with our diverse mission areas. A key tenet to our approach is to work with our mission partners to understand and anticipate their requirements and formulate an investment strategy that is aligned with those Laboratories priorities. In doing this, our investments include not only expanding the resources available for scientific computing and modeling and simulation, but also acquiring large-scale systems for data analytics, cloud computing, and Emulytics. We are also investigating new computer architectures in our advanced systems test bed to guide future platform designs and prepare for changes in our code development models. Our initial investments in large-scale institutional platforms that are optimized for Informatics and Emulytics work are serving a diverse customer base. We anticipate continued growth and expansion of these resources in the coming years as the use of these analytic techniques expands across our mission space. If your program could benefit from an investment in innovative systems, please work through your Program Management Unit ’s Mission Computing Council representatives to engage our teams.

  15. Annual Energy Review 2000

    SciTech Connect

    Seiferlein, Katherine E.

    2001-08-01

    The Annual Energy Review (AER) presents the Energy Information Administration’s historical energy statistics. For many series, statistics are given for every year from 1949 through 2000. The statistics, expressed in either physical units or British thermal units, cover all major energy activities, including consumption, production, trade, stocks, and prices, for all major energy commodities, including fossil fuels, electricity, and renewable energy sources. Publication of this report is required under Public Law 95–91 (Department of Energy Organization Act), Section 205(c), and is in keeping with responsibilities given to the Energy Information Administration under Section 205(a)(2), which states: “The Administrator shall be responsible for carrying out a central, comprehensive, and unified energy data and information program which will collect, evaluate, assemble, analyze, and disseminate data and information....” The AER is intended for use by Members of Congress, Federal and State agencies, energy analysts, and the general public. EIA welcomes suggestions from readers regarding data series in the AER and in other EIA publications.

  16. Annual Energy Review 2002

    SciTech Connect

    Seiferlein, Katherine E.

    2003-10-01

    The Annual Energy Review (AER) presents the Energy Information Administration’s historical energy statistics. For many series, statistics are given for every year from 1949 through 2002. The statistics, expressed in either physical units or British thermal units, cover all major energy activities, including consumption, production, trade, stocks, and prices, for all major energy commodities, including fossil fuels, electricity, and renewable energy sources. Publication of this report is required under Public Law 95–91 (Department of Energy Organization Act), Section 205(c), and is in keeping with responsibilities given to the Energy Information Administration (EIA) under Section 205(a)(2), which states: “The Administrator shall be responsible for carrying out a central, comprehensive, and unified energy data and information program which will collect, evaluate, assemble, analyze, and disseminate data and information....” The AER is intended for use by Members of Congress, Federal and State agencies, energy analysts, and the general public. EIA welcomes suggestions from readers regarding data series in the AER and in other EIA publications. Related Publication: Readers of the AER may also be interested in EIA’s Monthly Energy Review, which presents monthly updates of many of the data in the AER. Contact our National Energy Information Center for more information.

  17. 2007 LDRD ANNUAL REPORT

    SciTech Connect

    French, T

    2008-12-16

    I am pleased to present the fiscal year 2007 Laboratory Directed Research and Development (LDRD) annual report. This represents the first year that SRNL has been eligible for LDRD participation and our results to date demonstrate we are off to an excellent start. SRNL became a National Laboratory in 2004, and was designated the 'Corporate Laboratory' for the DOE Office of Environmental Management (EM) in 2006. As you will see, we have made great progress since these designations. The LDRD program is one of the tools SRNL is using to enable achievement of our strategic goals for the DOE. The LDRD program allows the laboratory to blend a strong basic science component into our applied technical portfolio. This blending of science with applied technology provides opportunities for our scientists to strengthen our capabilities and delivery. The LDRD program is vital to help SRNL attract and retain leading scientists and engineers who will help build SRNL's future and achieve DOE mission objectives. This program has stimulated our research staff creativity, while realizing benefits from their participation. This investment will yield long term dividends to the DOE in its Environmental Management, Energy, and National Security missions.

  18. Annual Energy Review 1997

    SciTech Connect

    Seiferlein, Katherine E.

    1998-07-01

    The Annual Energy Review (AER) presents the Energy Information Administration’s historical energy statistics. For many series, statistics are given for every year from 1949 through 1997. The statistics, expressed in either physical units or British thermal units, cover all major energy activities, including consumption, production, trade, stocks, and prices, for all major energy commodities, including fossil fuels, electricity, and renewable energy sources. Publication of this report is in keeping with responsibilities given to the Energy Information Administration (EIA) in Public Law 95–91 (Department of Energy Organization Act), which states, in part, in Section 205(a)(2) that: “The Administrator shall be responsible for carrying out a central, comprehensive, and unified energy data and information program which will collect, evaluate, assemble, analyze, and disseminate data and information....” The AER is intended for use by Members of Congress, Federal and State agencies, energy analysts, and the general public. EIA welcomes suggestions from readers regarding data series in the AER and in other EIA publications.

  19. Annual energy review 1992

    SciTech Connect

    Not Available

    1993-06-29

    This eleventh edition of the Annual Energy Review (AER) presents the Energy Information Administration`s historical energy statistics. For most series, statistics are given for every year from 1949 through 1992. Because coverage spans four decades, the statistics in this report are well-suited to tong-term trend analyses. The AER is comprehensive. It covers all major energy activities, including consumption, production, trade, stocks, and prices, all major energy commodities, including fossil fuels and electricity. The AER also presents statistics on some renewable energy sources. For the most part, fuel-specific data are expressed in physical units such as barrels, cubic feet, and short tons. The integrated summary data in Section 1 are expressed in Btu. The Btu values are calculated using the conversion factors in Appendix A. Statistics expressed in Btu are valuable in that they allow for comparisons among different fuels and for the calculation of in the integrated summary statistics such as US consumption of Energy. The AER emphasizes domestic energy statistics.

  20. Consensus on the Prevention, Screening, Early Diagnosis and Treatment of Colorectal Tumors in China: Chinese Society of Gastroenterology, October 14-15, 2011, Shanghai, China

    PubMed Central

    Fang, Jing-Yuan; Zheng, Shu; Jiang, Bo; Lai, Mao-De; Fang, Dian-Chun; Han, Ying; Sheng, Qian-Jiu; Li, Jing-Nan; Chen, Ying-Xuan; Gao, Qin-Yan

    2014-01-01

    Background Colorectal cancer (CRC) is steadily increasing in China. Colorectal adenoma (CRA) is the most important precancerous disease of CRC. Screening for colorectal tumors can aid early diagnosis. Advances in endoscopic mucosal resection and endoscopic submucosal dissection can aid the early treatment of colorectal tumors. Furthermore, because of high risk of recurrence after removal of adenomas under endoscopy, factors contributing to recurrence, the follow-up mode and the interval established, and the feasibility of application and the time of various chemical preventions should be concerned. However, a relevant consensus on the screening, early diagnosis and treatment, and prevention of colorectal tumors in China is lacking. Summary The consensus recommendations include epidemiology, pathology, screening, early diagnosis, endoscopic treatment, monitoring and follow-up, and chemoprevention of colorectal tumors in China. Key Message This is the first consensus on the prevention, screening, early diagnosis and treatment of CRA and CRC in China based on evidence in the literature and on local data. Practical Implications Through reviewing the literature, regional data and passing the consensus by an anonymous vote, gastroenterology experts from all over China launch the consensus recommendations in Shanghai. The incidence and mortality of CRC in China has increased, and the incidence or detection rate of CRA has increased rapidly. Screening for colorectal tumors should be performed at age 50-74 years. Preliminary screening should be undertaken to find persons at high risk, followed by colonoscopy. A screening cycle of 3 years is recommended for persistent interventions. Opportunistic screening is a mode suitable for the current healthcare system and national situation. Colonoscopy combined with pathological examination is the standard method for the diagnosis of colorectal tumors. CRA removal under endoscopy can prevent CRC to some extent, but CRA has an obvious

  1. The Risks and Benefits of Long-term Use of Proton Pump Inhibitors: Expert Review and Best Practice Advice From the American Gastroenterological Association.

    PubMed

    Freedberg, Daniel E; Kim, Lawrence S; Yang, Yu-Xiao

    2017-03-01

    The purpose of this review is to evaluate the risks associated with long-term use of proton pump inhibitors (PPIs), focusing on long-term use of PPIs for three common indications: gastroesophageal reflux disease (GERD), Barrett's esophagus (BE), and non-steroidal anti-inflammatory drug (NSAID) bleeding prophylaxis. The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed, EMbase, and the Cochrane library (through July 2016). To identify relevant ongoing trials, we queried clinicaltrials.gov. To assess the quality of evidence, we used a modified approach based on the GRADE Working Group. The Clinical Practice Updates Committee of the American Gastroenterological Association has reviewed these recommendations. Best Practice Advice 1: Patients with GERD and acid-related complications (ie, erosive esophagitis or peptic stricture) should take a PPI for short-term healing, maintenance of healing, and long-term symptom control. Best Practice Advice 2: Patients with uncomplicated GERD who respond to short-term PPIs should subsequently attempt to stop or reduce them. Patients who cannot reduce PPIs should consider ambulatory esophageal pH/impedance monitoring before committing to lifelong PPIs to help distinguish GERD from a functional syndrome. The best candidates for this strategy may be patients with predominantly atypical symptoms or those who lack an obvious predisposition to GERD (eg, central obesity, large hiatal hernia). Best Practice Advice 3: Patients with Barrett's esophagus and symptomatic GERD should take a long-term PPI. Best Practice Advice 4: Asymptomatic patients with Barrett's esophagus should consider a long-term PPI. Best Practice Advice 5: Patients at high risk for ulcer-related bleeding from NSAIDs should take a PPI if they continue to take NSAIDs. Best Practice Advice 6: The dose of long-term PPIs should be periodically reevaluated so that the lowest effective PPI dose can be prescribed to

  2. Does the cost of care differ for patients with fee-for-service vs. capitation of payment? A case-control study in gastroenterology.

    PubMed

    Slattery, E; Clancy, K X; Harewood, G C; Murray, F E; Patchett, S

    2013-12-01

    There is growing evidence to demonstrate overuse of medical resources in fee for service (FFS) payment models (in which physicians are reimbursed according to volume of care provided) compared to capitation payment models (in which physicians receive a fixed salary regardless of level of care provided). In this medical centre, patients with and without insurance are admitted through the same access point (emergency room) and cared for by the same physicians. Therefore, apart from insurance status, all other variables influencing delivery of care are similar for both patient groups. However, physician reimbursement differs for both groups: FFS for patients with private insurance (i.e. the admitting physician's reimbursement escalates progressively with each day that the patient spends in hospital) and base salary irrespective of care provided for patients with universal insurance (capitation payment model). All admitting physicians are aware of the patient's insurance status and the duration of hospitalization is at the discretion of the admitting physician. This study aimed to compare cost of care of patients with and without insurance admitted to a teaching hospital with a primary gastroenterology or hepatology (GIH) diagnosis. All hospital inpatients admitted between January 2008 and December 2009 with a primary GI-related diagnosis related group (DRG) were identified. Patients were classified as uninsured (state-funded) or privately insured. Only DRGs with at least five patients in both the insured and uninsured patient groups were analyzed to ensure a precise estimate of inpatient costs. Patient level costing (PLC) was used to express the total cost of hospital care for each patient; PLC comprised a weighted daily bed cost plus cost of all medical services provided (e.g. radiology, pathology tests) calculated according to an activity-based costing approach, cost of medications were excluded. An overall mean cost of care per patient was calculated for both

  3. The effect of cyclic rifaximin therapy on symptoms of diverticular disease from the perspective of the gastroenterology outpatient clinic: a "real-life" study.

    PubMed

    Moniuszko, Andrzej; Rydzewska, Grażyna

    2017-01-01

    Symptomatic uncomplicated diverticular disease of the colon (SUDD) is one of the most common diseases with which patients present to a gastroenterologist. Mild forms of diverticulitis can also be treated using rifaximin. Although numerous randomised controlled trials have already demonstrated the efficacy of rifaximin therapy, there is still a lack of data from daily medical practice. To assess the effect of rifaximin on the symptoms of diverticular disease (SUDD and mild diverticulitis) in patients undergoing routine treatment in gastroenterology outpatient clinics in Poland. The retrospective study included 142 patients with a diagnosis of SUDD and mild diverticulitis, with a mean age of 60-69 years (41%), of whom 65% were women. Patients underwent three cycles of rifaximin therapy at a dose of 2 × 400 mg daily for 7 days over 3 consecutive months. Survey data were collected during monthly clinic appointments using a questionnaire completed by 48 gastroenterologists, and in selected cases standard inflammatory parameters were also determined. After just one cycle of therapy a significant reduction in disease symptoms was observed (abdominal pain, abdominal tenderness, bloating, disturbances in bowel habit), defined over a scale of 0-3 points. The mean intensity of symptoms decreased from 1.7 ±0.7 to 0.8 ±0.3 points (with a maximum symptom intensity of 3.0 points). After three cycles, the severity of symptoms decreased markedly to an average of 0.3 ±0.1, and as many as 75% of patients reported no abdominal pain (previously the percentage was only 4%). These differences were statistically significant, p < 0.001. The decrease in inflammatory parameters (white blood cell count, C-reactive protein and erythrocyte sedimentation rate) was statistically significant. Rifaximin is highly effective in the symptomatic relief of uncomplicated diverticular disease of the large bowel, and it is also effective in the treatment of mild forms of diverticulitis. Although the

  4. 2005 Annual Report

    SciTech Connect

    Chrzanowski, P; Walter, K

    2006-03-31

    As the cover of our ''2005 Annual Report'' highlights, Lawrence Livermore National Laboratory joined the international science community in celebrating the World Year of Physics in 2005, with special events and science outreach and education programs. Einstein's remarkable discoveries in 1905 provided an opportunity to reflect on how physics has changed the world during the last century and on the promise of future beneficial discoveries. For half of the past century, Lawrence Livermore, which was established to meet an urgent national security need, has been contributing to the advancement of science and technology in a very special way. Co-founder Ernest O. Lawrence was the leading proponent in his generation of large-scale, multidisciplinary science and technology teams. That's Livermore's distinctive heritage and our continuing approach as a national laboratory managed and operated by the University of California for the Department of Energy's National Nuclear Security Administration (DOE/NNSA). We focus on important problems that affect our nation's security and seek breakthrough advances in science and technology to achieve mission goals. An event in 2005 exemplifies our focus on science and technology advances in support of mission goals. In October, distinguished visitors came to Livermore to celebrate the tenth anniversary of the Accelerated Strategic Computing Initiative (now called the Advanced Simulation and Computing Program, or ASC). ASC was launched in 1995 by DOE/NNSA to achieve a million-fold increase in computing power in a decade. The goal was motivated by the need to simulate the three-dimensional performance of a nuclear weapon in sufficient resolution and with the appropriately detailed physics models included. This mission-driven goal is a key part of fulfilling Livermore's foremost responsibility to ensure that the nuclear weapons in the nation's smaller 21st-century stockpile remain safe, reliable, and secure.

  5. Annual energy review 2003

    SciTech Connect

    Seiferlein, Katherin E.

    2004-09-30

    The Annual Energy Review 2003 is a statistical history of energy activities in the United States in modern times. Data are presented for all major forms of energy by production (extraction of energy from the earth, water, and other parts of the environment), consumption by end-user sector, trade with other nations, storage changes, and pricing. Much of the data provided covers the fossil fuels—coal, petroleum, and natural gas. Fossil fuels are nature’s batteries; they have stored the sun’s energy over millennia past. It is primarily that captured energy that we are drawing on today to fuel the activities of the modern economy. Data in this report measure the extraordinary expansion of our use of fossil fuels from 29 quadrillion British thermal units (Btu) in 1949 to 84 quadrillion Btu in 2003. In recent years, fossil fuels accounted for 86 percent of all energy consumed in the United States. This report also records the development of an entirely new energy industry—the nuclear electric power industry. The industry got its start in this country in 1957 when the Shippingport, Pennsylvania, nuclear electric power plant came on line. Since that time, the industry has grown to account for 20 percent of our electrical output and 8 percent of all energy used in the country. Renewable energy is a third major category of energy reported in this volume. Unlike fossil fuels, which are finite in supply, renewable energy is essentially inexhaustible because it can be replenished. Types of energy covered in the renewable category include conventional hydroelectric power, which is power derived from falling water; wood; waste; alcohol fuels; geothermal; solar; and wind. Together, these forms of energy accounted for about 6 percent of all U.S. energy consumption in recent years.

  6. Annual energy review 1997

    SciTech Connect

    1998-07-01

    The Annual Energy Review (AER) is a historical data report that tells many stories. It describes, in numbers, the changes that have occurred in US energy markets since the midpoint of the 20th century. In many cases, those markets differ vastly from those of a half-century ago. By studying the graphs and data tables presented in this report, readers can learn about past energy supply and usage in the United States and gain an understanding of the issues in energy and the environment now before use. While most of this year`s report content is similar to last year`s, there are some noteworthy developments. Table 1.1 has been restructured into more summarized groupings -- fossil fuels, nuclear electric power, and renewable energy -- to aid analysts in their examination of the basic trends in those broad categories. Readers` attention is also directed to the electricity section, where considerable reformatting of the tables and graphs has been carried out to help clarify past and recent trends in the electric power industry as it enters a period of radical restructuring. Table 9.1, which summarizes US nuclear generating units, has been redeveloped to cover the entire history of the industry in this country and to provide categories relevant in assessing the future of the industry, such as the numbers of ordered generating units that have been canceled and those that were built and later shut down. In general, the AER emphasizes domestic energy statistics. Sections 1 through 10 and Section 12 are devoted mostly to US data; Section 11 reports on international statistics and world totals. 140 figs., 141 tabs.

  7. Annual Research Briefs

    NASA Technical Reports Server (NTRS)

    Spinks, Debra (Compiler)

    1997-01-01

    This report contains the 1997 annual progress reports of the research fellows and students supported by the Center for Turbulence Research (CTR). Titles include: Invariant modeling in large-eddy simulation of turbulence; Validation of large-eddy simulation in a plain asymmetric diffuser; Progress in large-eddy simulation of trailing-edge turbulence and aeronautics; Resolution requirements in large-eddy simulations of shear flows; A general theory of discrete filtering for LES in complex geometry; On the use of discrete filters for large eddy simulation; Wall models in large eddy simulation of separated flow; Perspectives for ensemble average LES; Anisotropic grid-based formulas for subgrid-scale models; Some modeling requirements for wall models in large eddy simulation; Numerical simulation of 3D turbulent boundary layers using the V2F model; Accurate modeling of impinging jet heat transfer; Application of turbulence models to high-lift airfoils; Advances in structure-based turbulence modeling; Incorporating realistic chemistry into direct numerical simulations of turbulent non-premixed combustion; Effects of small-scale structure on turbulent mixing; Turbulent premixed combustion in the laminar flamelet and the thin reaction zone regime; Large eddy simulation of combustion instabilities in turbulent premixed burners; On the generation of vorticity at a free-surface; Active control of turbulent channel flow; A generalized framework for robust control in fluid mechanics; Combined immersed-boundary/B-spline methods for simulations of flow in complex geometries; and DNS of shock boundary-layer interaction - preliminary results for compression ramp flow.

  8. FY 2015 Annual Performance Report

    EPA Pesticide Factsheets

    Presents detailed performance results, as measured against the targets established in EPA’s FY 2015 Annual Plan and Budget. The Executive Overview section analyzes key performance outcomes and links to FY 2015 program evaluations.

  9. LLNL NESHAPs 2004 Annual Report

    SciTech Connect

    Harrach, R; Gallegos, G; Peterson, R; Wilson, K; Harrach, R J; Gallegos, G M; Peterson, S R; Wilson, K R

    2005-06-27

    This annual report is prepared pursuant to the National Emission Standards for Hazardous Air Pollutants (NESHAPs; Title 40 Code of Federal Regulations [CFR] Part 61, Subpart H). Subpart H governs radionuclide emissions to air from Department of Energy (DOE) facilities.

  10. Annual Performance Report - FY 2011

    EPA Pesticide Factsheets

    This report summarizes OIG activity, performance, results, and challenges, and provides a financial accounting of resources for fiscal year (FY) 2011 compared to our FY 2011 annual performance targets.

  11. FY 2016 Annual Performance Report

    EPA Pesticide Factsheets

    Presents detailed performance results, as measured against the targets established in EPA’s FY 2016 Annual Plan and Budget. The Executive Overview section analyzes key performance outcomes and links to FY 2016 program evaluations.

  12. Guideline for wireless capsule endoscopy in children and adolescents: A consensus document by the SEGHNP (Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition) and the SEPD (Spanish Society for Digestive Diseases).

    PubMed

    Argüelles-Arias, Federico; Donat, Ester; Fernández-Urien, Ignacio; Alberca, Fernando; Argüelles-Martín, Federico; Martínez, María José; Molina, Manuel; Varea, Vicente; Herrerías-Gutiérrez, Juan Manuel; Ribes-Koninckx, Carmen

    2015-12-01

    Capsule Endoscopy (CE) in children has limitations based mainly on age. The objective of this consensus was reviewing the scientific evidence. Some experts from the Spanish Society of Gastroenterology (SEPD) and Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition (SEGHNP) were invited to answer different issues about CE in children. These sections were: a) Indications, contraindications and limitations; b) efficacy of CE in different clinical scenarios; c) CE performance; d) CE-related complications; e) Patency Capsule; and f) colon capsule endoscopy. They reviewed relevant questions on each topic. The main indication is Crohn's disease (CD). There is no contraindication for the age and in the event that the patient not to swallow it, it should be administered under deep sedation with endoscopy and specific device. The CE is useful in CD, for the management of OGIB in children and in Peutz-Jeghers syndrome (in this indication has the most effectiveness). The main complication is retention, which should be specially taken into account in cases of CD already diagnosed with malnutrition. A preparation regimen based on a low volume of polyethylene glycol (PEG) the day before plus simethicone on the same day is the best one in terms of cleanliness although does not improve the results of the CE procedure. CE is safe and useful in children. Indications are similar to those of adults, the main one is CD to establish both a diagnosis and disease extension. Moreover, only few limitations are detected in children.

  13. NERI 2004 Annual Report

    SciTech Connect

    2004-01-01

    The United States Department of Energy (DOE) created the Nuclear Energy Research Initiative (NERI) in Fiscal Year (FY) 1999 in response to recommendations provided by the President's Committee of Advisors on Science and Technology. The purpose of NERI is to sponsor research and development (R&D) in the nuclear energy sciences to address the principal barriers to the future use of nuclear energy in the United States. NERI is helping to preserve the nuclear science and engineering infrastructure within the Nation's universities, laboratories, and industry, and is advancing the development of nuclear energy technology, enabling the United States to maintain a competitive position in nuclear science and technology. Research under this initiative also addresses issues associated with the maintenance of existing U.S. nuclear plants. The NERI program is managed and funded by DOE's Office of Nuclear Energy, Science and Technology. ''The Nuclear Energy Research Initiative 2004 Annual Report'' serves to inform interested parties of progress made in NERI on a programmatic level as well as research progress made on individual NERI projects. Section 2 of this report provides background on the creation and implementation of NERI and on the focus areas for NERI research. Section 3 provides a discussion on NERI's mission, goals and objectives, and work scope. Section 4 highlights the major accomplishments of the NERI projects and provides brief summaries of the NERI research efforts that were completed in 2004. Section 5 provides a discussion on the impact NERI has had on U.S. university nuclear programs. Sections 6 through 8 provide project status reports by research area for each of the fiscal year (FY) 2001 and 2002 projects that were active in FY 2004. Research objectives, progress made over the last year, and activities planned for the next year are described for each project. Sections 9 through 11 present each of the newly awarded 2005 NERI projects in their corresponding

  14. Engineering Annual Summary 1998

    SciTech Connect

    Dimolitsas, S

    1999-05-01

    Unlike most research and development laboratories, Lawrence Livermore National Laboratory (LLNL) is responsible for delivering production-ready designs. Unlike most industry, LLNL is responsible for R and D that must significantly increase the nation's security. This rare combination of production engineering expertise and national R and D agenda identifies LLNL as one of the few organizations today that conducts cutting-edge engineering on grand-scale problems, while facing enormous technical risk and undergoing diligent scrutiny of its budget, schedule, and performance. On the grand scale, cutting-edge technologies are emerging from our recent ventures into ''Xtreme Engineering{trademark}.'' Basically, we must integrate and extend technologies concurrently and then push them to their extreme, such as building very large structures but aligning them with extreme precision. As we extend these technologies, we push the boundaries of engineering capabilities at both poles: microscale and ultrascale. Today, in the ultrascale realm, we are building NIF, the world's largest laser, which demands one of the world's most complex operating systems with 9000 motors integrated through over 500 computers to control 60,000 points for every laser shot. On the other pole, we have fabricated the world's smallest surgical tools and the smallest instruments for detecting biological and chemical agents used by antiterrorists. Later in this Annual Summary, we highlight some of our recent innovations in the area of Xtreme Engineering, including large-scale computer simulations of massive structures such as major bridges to prepare retrofitting designs to withstand earthquakes. Another feature is our conceptual breakthrough in developing the world's fastest airplane, HyperSoar, which can reach anywhere in the planet in two hours at speeds of 6700 mph. In the last few years, Engineering has significantly pushed the technology in structural mechanics and micro-instrumentation. For example

  15. 77 FR 64463 - Annual Retail Trade Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-22

    ..., the Census Bureau will collect data covering annual sales, annual e- commerce sales, year-end..., accounts receivables, and, for selected industries, merchandise line sales, and percent of e-commerce sales..., annual sales, annual e-commerce sales, purchases, total and detailed operating expenses,...

  16. 78 FR 64912 - Annual Retail Trade Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... survey, the Census Bureau will collect data covering annual sales, annual e-commerce sales, year-end... annual sales, annual e-commerce sales, year-end inventories held inside and outside the United States... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF...

  17. 75 FR 63804 - Annual Retail Trade Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-18

    ... survey, the Census Bureau will collect data covering annual sales, annual e-commerce sales, year-end... percent of e-commerce sales to customers located outside the United States. These data are collected to... classification basis, annual sales, annual e-commerce sales, purchases, total operating expenses,...

  18. Stockholder Reactions to Corporate Annual Reports.

    ERIC Educational Resources Information Center

    Means, Thomas Lee

    A study was conducted to assess the extent to which (1) stockholders consider corporate annual reports to be informative and useful, (2) they actually read annual reports, (3) they consider annual reports to be impressive, and (4) they are motivated by the annual report to invest further in corporations in which they already own stock. After the…

  19. 22 CFR 62.15 - Annual reports.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Annual reports. 62.15 Section 62.15 Foreign... § 62.15 Annual reports. Sponsors shall submit an annual report to the Department of State. An... desire for redesignation, pursuant to § 62.7, by marking the appropriate box on their annual report....

  20. 7 CFR 3400.23 - Annual reports.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Annual reports. 3400.23 Section 3400.23 Agriculture... SERVICE, DEPARTMENT OF AGRICULTURE SPECIAL RESEARCH GRANTS PROGRAM Annual Reports § 3400.23 Annual reports. (a) Reporting requirement. The recipient shall submit an annual report describing the results of...

  1. 25 CFR 122.9 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Annual report. 122.9 Section 122.9 Indians BUREAU OF... EDUCATION § 122.9 Annual report. The Osage Tribal Education Committee shall submit an annual report on OMB approved Form 1076-0106, Higher Education Annual Report, to the Assistant Secretary or his/her...

  2. 16 CFR 1018.42 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Annual report. 1018.42 Section 1018.42... Reports and Audits § 1018.42 Annual report. (a) The Advisory Committee Management Officer shall prepare an annual report on the Commission's advisory committees for inclusion in the President's annual report...

  3. 49 CFR 195.49 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Annual report. 195.49 Section 195.49... PIPELINE Annual, Accident, and Safety-Related Condition Reporting § 195.49 Annual report. Beginning no... dioxide pipelines. Operators are encouraged, but not required, to file an annual report by June 15,...

  4. 21 CFR 1002.13 - Annual reports.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Annual reports. 1002.13 Section 1002.13 Food and... Annual reports. (a) Every manufacturer of products requiring an annual report as specified in table 1 of § 1002.1 shall submit an annual report summarizing the contents of the records required to be...

  5. 7 CFR 900.355 - Annual reporting.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Annual reporting. 900.355 Section 900.355 Agriculture... Determining the Qualification of Cooperative Milk Marketing Associations § 900.355 Annual reporting... qualified pursuant to the Act is required to file an annual report after its annual meeting has been...

  6. FY 1994 Annual Work Plan

    SciTech Connect

    Not Available

    1993-09-30

    In accordance with the Inspector General`s Strategic Planning Policy directive, the Office of Inspector General (OIG) annually updates its Strategic Plan with budgetary and program guidance for the next fiscal year. The program guidance identifies and establishes priorities for OIG coverage of important DOE issues and operations, provides the basis for assigning OIG resources, and is the source for issues covered in Assistant Inspectors General annual work plans. The Office of the Assistant Inspector General for Audits (AIGA) publishes an Annual Work Plan in September of each year. The plan includes the OIG program guidance and shows the commitment of resources necessary to accomplish the assigned work and meet our goals. The program guidance provides the framework within which the AIGA work will be planned and accomplished. Audits included in this plan are designed to help insure that the requirements of our stakeholders have been considered and blended into a well balanced audit program.

  7. LLNL NESHAP's 1999 Annual Report

    SciTech Connect

    Gallegos, G.; Biermann, A.H.; Harrach, R.J.; Bertoldo, N.A.; Berger, R.L.; Surano,K.A.

    2000-06-01

    This annual report is prepared pursuant to the National Emissions Standards for Hazardous Air Pollutants (NESHAPs) 40 CFR Part 61, Subpart H; Subpart H governs radionuclide emissions to air from Department of Energy (DOE) facilities. NESHAPs limits the emission of radionuclides to the ambient air from DOE facilities to levels resulting in an annual effective dose equivalent (EDE) of 10 mrem (100 {micro}Sv) to any member of the public. The EDEs for the Lawrence Livermore National Laboratory (LLNL) site-wide maximally exposed members of the public from 1999 operations are summarized.

  8. USGS Annual Water Data Reports

    SciTech Connect

    2012-04-01

    Water resources data are published annually for use by engineers, scientists, managers, educators, and the general public. These archival products supplement direct access to current and historical water data provided by the National Water Information System (NWIS). Beginning with Water Year 2006, annual water data reports are available as individual electronic Site Data Sheets for the entire Nation for retrieval, download, and localized printing on demand. National distribution includes tabular and map interfaces for search, query, display and download of data. Data provided include extreme and mean discharge rates.

  9. IFLA Annual 1970; Proceedings of the General Council Annual Reports.

    ERIC Educational Resources Information Center

    Thompson, Anthony, Ed.

    The IFLA Annual 1970 is divided into two sections. Section one is the IFLA General Council Proceedings and contains: (1) the Opening Plenary Session; (2) the Plenary Session on the theme "Libraries as a Force in Education;" (3) the Plenary Session on the theme "Lenin and Libraries;" and (4) the reports on activities, meetings in Moscow, and…

  10. 77 FR 61737 - Annual Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-11

    ... From the Federal Register Online via the Government Publishing Office APPALACHIAN STATES LOW-LEVEL RADIOACTIVE WASTE COMMISSION Annual Meeting Time and Date: 10 a.m.-12 p.m. November 2, 2012. Place: Harrisburg...-2012; (2) Review the Low- Level Radioactive Waste (LLRW) generation information for 2010; (3) Consider...

  11. 75 FR 65297 - Annual Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-22

    ... From the Federal Register Online via the Government Publishing Office APPALACHIAN STATES LOW-LEVEL RADIOACTIVE WASTE COMMISSION Annual Meeting Time And Date: 10 a.m.-12:30 p.m., November 5, 2010. Place... year 2009-2010; (2) Review the Low- Level Radioactive Waste (LLRW) Disposal and Storage information for...

  12. 76 FR 64071 - Annual Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-17

    ... From the Federal Register Online via the Government Publishing Office APPALACHIAN STATES LOW-LEVEL RADIOACTIVE WASTE COMMISSION Annual Meeting Time and Date: 10 a.m.-12:30 p.m. November 4, 2011. Place... year 2010-2011; (2) Review the Low- Level Radioactive Waste (LLRW) ] Disposal and Storage information...

  13. 78 FR 64472 - Annual Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ... From the Federal Register Online via the Government Publishing Office APPALACHIAN STATES LOW-LEVEL RADIOACTIVE WASTE COMMISSION Annual Meeting Time and Date: 10 a.m.-12 p.m. October 31, 2013. Place: Harrisburg...-2013; (2) Review the Low- Level Radioactive Waste (LLRW) generation information for 2012; (3) Consider...

  14. FY 1994 Annual Work Plan

    SciTech Connect

    Not Available

    1993-10-01

    This is the third Office of Inspector General (OIG)Annual Work Plan. Its purpose is to summarize work completed in Fiscal Year (FY) 1993, identify ongoing projects from previous fiscal years which the OIG intends to continue into FY 1994, and announce planned projects which the OIG intends to begin in FY 19994.

  15. Spinoff 1978: An Annual Report.

    ERIC Educational Resources Information Center

    National Aeronautics and Space Administration, Washington, DC.

    This abstract is the annual report of NASA's Technology Utilization Program, which is charged with promoting and stimulating the practical application of government-sponsored aerospace technology. The report is organized in three sections: (1) aerospace aims; (2) technology twice used; and (3) technology utilization. Section 1 outlines NASA's…

  16. Facing Facts. Annual Report, 2005

    ERIC Educational Resources Information Center

    Wallace Foundation, The, 2006

    2006-01-01

    This annual report highlights the work of some grantees who are finding innovative ways to respond to today's new challenges based on a rigorous commitment by their leadership to gathering pertinent facts. These include cities that are planning wide-scale, lasting improvements in arts learning or out-of-school opportunities, basing their choices…

  17. 1982 laser program annual report

    SciTech Connect

    Hendricks, C.D.; Grow, G.R.

    1983-08-01

    This annual report covers the following eight sections: (1) laser program review, (2) laser systems and operation, (3) target design, (4) target fabrication, (5) fusion experiments program, (6) Zeus laser project, (7) laser research and development, and (8) energy applications. (MOW)

  18. Annual Report, Fiscal Year 1983.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    As mandated by Congress, this annual report from the U.S. Department of Education (ED) describes its activities in the past fiscal year (FY). Secretary of Education, T. H. Bell, summarizes ED accomplishments in FY 1983 in such areas as excellence in education, citing the findings and impact of the report "A Nation at Risk"; the…

  19. Strategic petroleum reserve annual report

    SciTech Connect

    1996-02-15

    Section 165 of the Energy Policy and Conservation Act (Public Law 94- 163), as amended, requires the Secretary of Energy to submit annual reports to the President and the Congress on activities of the Strategic Petroleum Reserve (SPR). This report describes activities for the year ending December 31, 1995.

  20. 2014 Fordham Sponsorship Annual Report

    ERIC Educational Resources Information Center

    Thomas B. Fordham Foundation, 2014

    2014-01-01

    The 2014 Fordham Sponsorship Annual Report is our opportunity to share the Fordham Foundation's work as the sponsor of eleven schools serving 3,200 students, and our related policy work in Ohio and nationally. We are fortunate as an organization that our policy work benefits our sponsorship efforts; and, that our lessons from sponsorship inform…

  1. Louisiana Believes: Annual Report 2013

    ERIC Educational Resources Information Center

    Louisiana Department of Education, 2013

    2013-01-01

    "Louisiana Believes" is the state's comprehensive plan to ensure every student is on track to a professional career or a college degree. This annual report details Louisiana's progress toward that objective during the 2012-2013 school year, along with strategy for the coming school year. "Louisiana Believes" has three…

  2. Spinoff 1978: An Annual Report.

    ERIC Educational Resources Information Center

    National Aeronautics and Space Administration, Washington, DC.

    This abstract is the annual report of NASA's Technology Utilization Program, which is charged with promoting and stimulating the practical application of government-sponsored aerospace technology. The report is organized in three sections: (1) aerospace aims; (2) technology twice used; and (3) technology utilization. Section 1 outlines NASA's…

  3. Literacy House: Annual Report 1968.

    ERIC Educational Resources Information Center

    Literacy House, Lucknow (India).

    The 1968 annual report of Literacy House focuses on functional literacy, food production, and family planning as well as on structural reorganization. A new organizational chart is included and the role of each individual in the organization is presented. The primary functions (training and research), and some details about the work of the…

  4. The German Photographic Annual; 1972.

    ERIC Educational Resources Information Center

    Strache, Wolf, Ed.; Steinert, Otto, Ed.

    Designed as a forum for the creative photographer who can produce work of an outstanding character, this 18th edition of the annual presents over 160 photographs whose themes range from advertising and industrial pictures, through unusual pictorial solutions in fashion photography, to experimental work, novel nude studies, and dramatic landscapes.…

  5. Peace Corps Seventh Annual Report.

    ERIC Educational Resources Information Center

    Vaughn, Jack, Ed.

    This seventh annual report of the Peace Corps states that the two greatest achievements of 1968 are intangible. First, the Peace Corps achieved a new measure of cooperation with the people in its host countries. In the summer of 1968 for the first time, hosts helped to recruit volunteers in the United States and became members of overseas staffs.…

  6. Peace Corps. Tenth Annual Report.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC.

    Projects, operations, and future plans are covered in this annual report for the tenth year of the Peace Corps. An overview focuses on Peace Corps success in providing technical assistance to aid development plans for the seventies and in responding to local needs as well as on its failures. The next section considers the Peace Corps response to…

  7. Communication Yearbook 5. Annual Review.

    ERIC Educational Resources Information Center

    Burgoon, Michael, Ed.

    The fifth in a series of annual volumes published by the International Communication Association, this yearbook provides reviews, overviews, and syntheses of developments in the evolution of the science of communication. The 40 articles in the volume are categorized as follows: (1) communication reviews and commentaries, including issues in…

  8. Communication Yearbook 5. Annual Review.

    ERIC Educational Resources Information Center

    Burgoon, Michael, Ed.

    The fifth in a series of annual volumes published by the International Communication Association, this yearbook provides reviews, overviews, and syntheses of developments in the evolution of the science of communication. The 40 articles in the volume are categorized as follows: (1) communication reviews and commentaries, including issues in…

  9. Migrant Ministry, 1967. Annual Report.

    ERIC Educational Resources Information Center

    National Council of Churches of Christ, New York, NY.

    The first annual meeting of the Migrant Ministry Section discussed and evaluated 10 policy and program goals established for the Fifth Decade. The result was the adoption and assignment for implementation of recommendations in 5 Task Force areas concerning migrant labor, education, and training. Significant parts of 35 state reports are presented…

  10. CIEE 1993 annual conference: Program

    SciTech Connect

    Not Available

    1993-08-01

    The California Institute for Energy efficiency`s third annual conference highlights the results of CIEE-sponsored multiyear research in three programs: Building Energy Efficiency, Air Quality Impacts of Energy Efficiency, and End-Use Resource Planning. Results from scoping studies, Director`s discretionary research, and exploratory research are also featured.

  11. Maine's annual inventory: state perspectives

    Treesearch

    Kenneth M. Laustsen

    2000-01-01

    In 1999, Maine became the first northeastern state to begin implementing the USDA Forest Service's annual inventory system as directed by PL 105- 185, the Agricultural Research, Extension, and Education Reform Act of 1998. The Maine Forest Service, in collaboration with Forest Inventory and Analysis program of the Northeastern Research Station of the USDA Forest...

  12. Preparing for the Annual Audit.

    ERIC Educational Resources Information Center

    Nuehring, Bert

    2002-01-01

    Proposes several key questions that school district business officials should answer to prepare for an annual financial audit involving auditor information and resource needs, district and auditor monitoring and reporting on the audit progress, and reporting the results of the audit to the board of education. (PKP)

  13. The German Photographic Annual; 1972.

    ERIC Educational Resources Information Center

    Strache, Wolf, Ed.; Steinert, Otto, Ed.

    Designed as a forum for the creative photographer who can produce work of an outstanding character, this 18th edition of the annual presents over 160 photographs whose themes range from advertising and industrial pictures, through unusual pictorial solutions in fashion photography, to experimental work, novel nude studies, and dramatic landscapes.…

  14. Education International Annual Report, 2001.

    ERIC Educational Resources Information Center

    Education International, Brussels (Belgium).

    In 2001, Education International (EI) achieved a high level of program implementation. This report provides a summary of that action. It is the first annual report and the last dealing with an earlier approach to programming. Following a review of ways of enhancing membership participation, the EI World Congress adopted a new approach to the…

  15. Non-alcoholic Fatty Liver Disease and Metabolic Syndrome-Position Paper of the Indian National Association for the Study of the Liver, Endocrine Society of India, Indian College of Cardiology and Indian Society of Gastroenterology.

    PubMed

    Duseja, Ajay; Singh, Shivaram P; Saraswat, Vivek A; Acharya, Subrat K; Chawla, Yogesh K; Chowdhury, Subhankar; Dhiman, Radha K; Jayakumar, Rohinivilasam V; Madan, Kaushal; Misra, Sri P; Mishra, Hrudananda; Modi, Sunil K; Muruganathan, Arumugam; Saboo, Banshi; Sahay, Rakesh; Upadhyay, Rajesh

    2015-03-01

    Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic syndrome. Prevalence of metabolic risk factors including diabetes mellitus, obesity, etc. is rapidly increasing in India putting this population at risk for NAFLD. Patients with NAFLD are at increased risk for liver-related morbidity and mortality and also cardiovascular disease risk and increased incidence of diabetes mellitus on long-term follow-up. Management of patients with NAFLD may require a multi-disciplinary approach involving not only the hepatologists but also the internists, cardiologists, and endocrinologists. This position paper which is a combined effort of the Indian National Association for Study of the Liver (INASL), Endocrine Society of India (ESI), Indian College of Cardiology (ICC) and the Indian Society of Gastroenterology (ISG) defines the spectrum of NAFLD and the association of NAFLD with insulin resistance and metabolic syndrome besides suggesting preferred approaches for the diagnosis and management of patients with NAFLD in the Indian context.

  16. Non-alcoholic Fatty Liver Disease and Metabolic Syndrome—Position Paper of the Indian National Association for the Study of the Liver, Endocrine Society of India, Indian College of Cardiology and Indian Society of Gastroenterology

    PubMed Central

    Duseja, Ajay; Singh, Shivaram P.; Saraswat, Vivek A.; Acharya, Subrat K.; Chawla, Yogesh K.; Chowdhury, Subhankar; Dhiman, Radha K.; Jayakumar, Rohinivilasam V.; Madan, Kaushal; Misra, Sri P.; Mishra, Hrudananda; Modi, Sunil K.; Muruganathan, Arumugam; Saboo, Banshi; Sahay, Rakesh; Upadhyay, Rajesh

    2015-01-01

    Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic syndrome. Prevalence of metabolic risk factors including diabetes mellitus, obesity, etc. is rapidly increasing in India putting this population at risk for NAFLD. Patients with NAFLD are at increased risk for liver-related morbidity and mortality and also cardiovascular disease risk and increased incidence of diabetes mellitus on long-term follow-up. Management of patients with NAFLD may require a multi-disciplinary approach involving not only the hepatologists but also the internists, cardiologists, and endocrinologists. This position paper which is a combined effort of the Indian National Association for Study of the Liver (INASL), Endocrine Society of India (ESI), Indian College of Cardiology (ICC) and the Indian Society of Gastroenterology (ISG) defines the spectrum of NAFLD and the association of NAFLD with insulin resistance and metabolic syndrome besides suggesting preferred approaches for the diagnosis and management of patients with NAFLD in the Indian context. PMID:25941433

  17. Indications for liver transplantation in adults : Recommendations of the Austrian Society for Gastroenterology and Hepatology (ÖGGH) in cooperation with the Austrian Society for Transplantation, Transfusion and Genetics (ATX).

    PubMed

    Graziadei, Ivo; Zoller, Heinz; Fickert, Peter; Schneeberger, Stefan; Finkenstedt, Armin; Peck-Radosavljevic, Markus; Müller, Helmut; Kohl, Claudia; Sperner-Unterweger, Barbara; Eschertzhuber, Stephan; Hofer, Harald; Öfner, Dietmar; Tilg, Herbert; Vogel, Wolfgang; Trauner, Michael; Berlakovich, Gabriela

    2016-10-01

    Liver transplantation has emerged as an established and well-accepted therapeutic option for patients with acute and chronic liver failure and hepatocellular carcinoma. The disproportion between recipients and donors is still an ongoing problem that has only been solved partially over the last centuries. For several patients no life-saving organs can be distributed. Therefore, objective and internationally established recommendations regarding indication and organ allocation are imperative. The aim of this article is to establish evidence-based recommendations regarding the evaluation and assessment of adult candidates for liver transplantation. This publication is the first Austrian consensus paper issued and approved by the Austrian Society of Gastroenterology and Hepatology in cooperation with the Austrian Society of Transplantation, Infusion and Genetics.

  18. White Paper AGA: An Episode-of-Care Framework for the Management of Obesity-Moving Toward High Value, High Quality Care: A Report From the American Gastroenterological Association Institute Obesity Episode of Care and Bundle Initiative Work Group.

    PubMed

    Brill, Joel V; Ashmore, Jamile A; Brengman, Matthew L; Buffington, Daniel E; Feldshon, S David; Friedman, Kelli E; Margolis, Peter S; Markus, Danielle; Narramore, Leslie; Rastogi, Amita; Starpoli, Anthony A; Strople, Kenneth; White, Jane V; Streett, Sarah E

    2017-02-24

    The American Gastroenterological Association acknowledges the need for gastroenterologists to participate in and provide value-based care for both cognitive and procedural conditions. Episodes of care are designed to engage specialists in the movement toward fee for value, while facilitating improved outcomes and patient experience and a reduction in unnecessary services and overall costs. The episode of care model puts the patient at the center of all activity related to their particular diagnosis, procedure, or health care event, rather than on a physician's specific services. It encourages and incents communication, collaboration, and coordination across the full continuum of care and creates accountability for the patient's entire experience and outcome. This paper outlines a collaborative approach involving multiple stakeholders for gastrointestinal practices to assess their ability to participate in and implement an episode of care for obesity and understand the essentials of coding and billing for these services.

  19. World Health Organization 2006 child growth standards and 2007 growth reference charts: A discussion paper by the committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

    PubMed

    Turck, Dominique; Michaelsen, Kim F; Shamir, Raanan; Braegger, Christian; Campoy, Cristina; Colomb, Virginie; Decsi, Tamás; Domellöf, Magnus; Fewtrell, Mary; Kolacek, Sanja; Mihatsch, Walter; Moreno, Luis A; van Goudoever, Johannes

    2013-08-01

    Growth charts are essential for evaluating children's health including their nutrition; however, the evaluation of child growth trajectories and consequently the decision to intervene are highly dependent on the growth charts used. The aim of this discussion paper of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition is to provide information on the background and rationale of the World Health Organization (WHO) 2006 child growth standards and WHO 2007 growth reference charts, describe their development, outline their main innovative aspects, discuss potential limitations, and make recommendations. WHO 2006 child growth standards (0-5 years) are based on prospectively collected data describing the growth of healthy infants who were breast-fed according to WHO recommendations, showing a pattern of linear growth, which is remarkably consistent between different countries and ethnic groups. WHO 2007 growth reference charts (5-19 years) are based mainly on a re-analysis of National Centre for Health Statistics data from 1977, without information on feeding. European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition recommends that WHO child growth standards should be used to monitor growth in all children in the age range 0 to 2 years in Europe, whether breast- or formula-fed, and that they should be considered to be used in the age range 2 to 5 years. Implementation of the WHO child growth standards should be preceded by evaluation of the implication of their use on national healthcare policies. Health professionals should be guided on their use and interpretation and an adequate communication strategy should be available locally to ensure that parents receive clear and consistent advice. The decision on whether to implement the WHO growth references (5-19 years) should be made by national bodies because the growth pattern during the 5- to 19-year period differs between

  20. Joint BAPEN and British Society of Gastroenterology Symposium on 'Coeliac disease: basics and controversies'. Dietitians are better than clinicians in following up coeliac disease.

    PubMed

    Stuckey, Claire; Lowdon, Jacqui; Howdle, Peter

    2009-08-01

    It seems obvious to healthcare professionals that patients with coeliac disease should receive regular follow-up. Surprisingly, there is little evidence that patients benefit in terms of reduced morbidity or mortality. However, several authoritative bodies have published guidelines on the management of coeliac disease that recommend regular follow-up. There is good evidence that compliance with a gluten-free diet reduces the risk of complications such as osteoporosis or small bowel lymphoma. Compliance is enhanced particularly by education about the disease and the gluten-free diet and by support from peers or professionals. Such input can be provided by regular follow-up, which thereby should improve compliance and hence long-term health. The consensus of the recommendations for follow-up suggests an annual review by a physician and dietitian. At annual follow-up the disease status can be checked and nutritional advice can be given, including checking the adequacy of, and the compliance with, the gluten-free diet. Complications and associated medical conditions can be sought, genetic risks explained and support and reassurance given. Specialist dietitians have particular expertise in relation to diet and nutritional management; specialist clinicians have a broader range of expertise in many aspects of management of the disease. A team approach for providing follow-up is the ideal, with a clinician and dietitian, both with expertise in coeliac disease, being involved. No one particular group of healthcare professionals is necessarily better than the other at providing follow-up.

  1. 42 CFR 419.50 - Annual review.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... PROGRAM PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Updates § 419.50 Annual review. (a) General rule. Not less often than annually, CMS reviews and updates groups, relative...

  2. 2016 Annual Technology Baseline (ATB) - Webinar Presentation

    SciTech Connect

    Cole, Wesley; Kurup, Parthiv; Hand, Maureen; Feldman, David; Sigrin, Benjamin; Lantz, Eric; Stehly, Tyler; Augustine, Chad; Turchi, Craig; Porro, Gian; O'Connor, Patrick; Waldoch, Connor

    2016-09-13

    This deck was presented for the 2016 Annual Technology Baseline Webinar. The presentation describes the Annual Technology Baseline, which is a compilation of current and future cost and performance data for electricity generation technologies.

  3. 28 CFR 16.208 - Annual report.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Annual report. 16.208 Section 16.208 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION Public Observation of Parole Commission Meetings § 16.208 Annual report. The Commission shall report annually...

  4. 28 CFR 16.208 - Annual report.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Annual report. 16.208 Section 16.208 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION Public Observation of Parole Commission Meetings § 16.208 Annual report. The Commission shall report annually...

  5. 28 CFR 16.208 - Annual report.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Annual report. 16.208 Section 16.208 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION Public Observation of Parole Commission Meetings § 16.208 Annual report. The Commission shall report annually...

  6. 28 CFR 16.208 - Annual report.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Annual report. 16.208 Section 16.208 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION Public Observation of Parole Commission Meetings § 16.208 Annual report. The Commission shall report annually...

  7. 12 CFR 35.7 - Annual reports.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 1 2011-01-01 2011-01-01 false Annual reports. 35.7 Section 35.7 Banks and... AGREEMENTS § 35.7 Annual reports. (a) Applicability date. This section applies only to covered agreements entered into on or after May 12, 2000. (b) Annual report required. Each NGEP and each insured...

  8. 12 CFR 133.7 - Annual reports.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 1 2013-01-01 2013-01-01 false Annual reports. 133.7 Section 133.7 Banks and... AGREEMENTS § 133.7 Annual reports. (a) Applicability date. This section applies only to covered agreements entered into on or after May 12, 2000. (b) Annual report required. Each NGEP and each insured...

  9. 12 CFR 35.7 - Annual reports.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 1 2013-01-01 2013-01-01 false Annual reports. 35.7 Section 35.7 Banks and... AGREEMENTS § 35.7 Annual reports. (a) Applicability date. This section applies only to covered agreements entered into on or after May 12, 2000. (b) Annual report required. Each NGEP and each insured...

  10. 12 CFR 207.7 - Annual reports.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 2 2011-01-01 2011-01-01 false Annual reports. 207.7 Section 207.7 Banks and... OF CRA-RELATED AGREEMENTS (REGULATION G) § 207.7 Annual reports. (a) Applicability date. This section applies only to covered agreements entered into on or after May 12, 2000. (b) Annual report required....

  11. 7 CFR 1773.3 - Annual audit.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false Annual audit. 1773.3 Section 1773.3 Agriculture... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.3 Annual audit. (a) Each borrower... RUS as set forth in § 1773.4. (b) Each borrower must establish an annual as of audit date within...

  12. 28 CFR 16.208 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Annual report. 16.208 Section 16.208 Judicial Administration DEPARTMENT OF JUSTICE PRODUCTION OR DISCLOSURE OF MATERIAL OR INFORMATION Public Observation of Parole Commission Meetings § 16.208 Annual report. The Commission shall report annually to...

  13. 22 CFR 62.15 - Annual reports.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Annual reports. 62.15 Section 62.15 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM General Provisions § 62.15 Annual reports. Sponsors shall submit an annual report to the Department of State....

  14. 76 FR 69239 - Annual Retail Trade Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-08

    ... survey, the Census Bureau will collect data covering annual sales, annual e-commerce sales, year-end... receivables, and, for selected industries, merchandise line sales, and percent of e-commerce sales to..., annual e-commerce sales, purchases, total operating expenses, accounts receivables, and...

  15. 78 FR 23960 - Annual Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-23

    ... THE FOOD AND DRUG ADMINISTRATION Annual Public Meeting ACTION: Notice of annual meeting. SUMMARY: The Reagan-Udall Foundation for the Food and Drug Administration (FDA), which was created by Title VI of the Food and Drug Amendments of 2007, is announcing an annual open public meeting. The Foundation...

  16. 77 FR 26585 - Annual Public Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-04

    ... THE FOOD AND DRUG ADMINISTRATION Annual Public Meeting ACTION: Notice of annual meeting. SUMMARY: The Reagan-Udall Foundation for the Food and Drug Administration (FDA), which was created by Title VI of the Food and Drug Amendments of 2007, is announcing an annual open public meeting. The Foundation...

  17. 42 CFR 457.750 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Annual report. 457.750 Section 457.750 Public..., Reporting, and Evaluation § 457.750 Annual report. (a) Report required for each Federal fiscal year. A State... State's assessment of the operation of the State plan. (b) Contents of annual report. In the...

  18. 34 CFR 300.715 - Annual reports.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Annual reports. 300.715 Section 300.715 Education... Interior § 300.715 Annual reports. (a) In general. The advisory board established under § 300.714 must prepare and submit to the Secretary of the Interior and to Congress an annual report containing...

  19. 32 CFR 295.8 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Annual report. 295.8 Section 295.8 National... INFORMATION ACT PROGRAM OFFICE OF THE INSPECTOR GENERAL, FREEDOM OF INFORMATION ACT PROGRAM § 295.8 Annual report. The FOIA Annual Report, assigned Report Control System DD-PA (A) 1365, will be prepared by...

  20. 5 CFR 2411.15 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Annual report. 2411.15 Section 2411.15....15 Annual report. On or before February 1 annually, the Chief FOIA Officer of the Authority shall submit a report of the activities of the Authority, the General Counsel, the Panel, and the IG...

  1. 29 CFR 1401.37 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Annual report. 1401.37 Section 1401.37 Labor Regulations... Disclosure of Information § 1401.37 Annual report. The Office of the Director shall annually, within 60 days following the close of each calendar year, prepare a report covering each of the categories or records to...

  2. 28 CFR 43.4 - Annual reports.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Annual reports. 43.4 Section 43.4... TREATMENT FURNISHED BY THE UNITED STATES § 43.4 Annual reports. The head of each Department or Agency concerned, or his designee, shall report annually to the Attorney General, by March 1, commencing in...

  3. 5 CFR 1631.18 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Annual report. 1631.18 Section 1631.18... Disclosure of Records Under the Freedom of Information Act, 5 U.S.C. 552 § 1631.18 Annual report. The Executive Director will submit annually, on or before February 1, a Freedom of Information report...

  4. 42 CFR 1007.17 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Annual report. 1007.17 Section 1007.17 Public... STATE MEDICAID FRAUD CONTROL UNITS § 1007.17 Annual report. At least 60 days prior to the expiration of... (the first 9 months of the certification period for the first annual report), and containing...

  5. 27 CFR 18.65 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Annual report. 18.65... OF THE TREASURY LIQUORS PRODUCTION OF VOLATILE FRUIT-FLAVOR CONCENTRATE Records and Reports § 18.65 Annual report. An annual report, on Form 1695(5520.2), of concentrate plant operations shall be...

  6. 15 CFR 16.14 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Annual report. 16.14 Section 16.14 Commerce and Foreign Trade Office of the Secretary of Commerce PROCEDURES FOR A VOLUNTARY CONSUMER PRODUCT INFORMATION LABELING PROGRAM § 16.14 Annual report. The Secretary will prepare an annual report of...

  7. 7 CFR 924.34 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Annual report. 924.34 Section 924.34 Agriculture....34 Annual report. The committee shall, prior to the last day of each fiscal period, prepare and mail an annual report to the Secretary and make a copy available to each handler and grower who requests...

  8. 23 CFR 1200.33 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Annual report. 1200.33 Section 1200.33 Highways NATIONAL... § 1200.33 Annual report. Within 90 days after the end of the fiscal year, each State shall submit an Annual Report. This report shall describe: (a) The State's progress in meeting its highway safety...

  9. 29 CFR 409.2 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Annual report. 409.2 Section 409.2 Labor Regulations... REPORTS BY SURETY COMPANIES § 409.2 Annual report. Each surety company having in force any bond required...-Management Standards a report, on U.S. Department of Labor Form S-1 entitled “Surety Company Annual Report”...

  10. 12 CFR 35.7 - Annual reports.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Annual reports. 35.7 Section 35.7 Banks and... AGREEMENTS § 35.7 Annual reports. (a) Applicability date. This section applies only to covered agreements entered into on or after May 12, 2000. (b) Annual report required. Each NGEP and each insured...

  11. 15 CFR 9.11 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Annual report. 9.11 Section 9.11... FOR HOUSEHOLD APPLIANCES AND EQUIPMENT TO EFFECT ENERGY CONSERVATION § 9.11 Annual report. The Secretary will prepare an annual report of activities under the program, including an evaluation of...

  12. 7 CFR 947.35 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Annual report. 947.35 Section 947.35 Agriculture... Administrative Committee § 947.35 Annual report. The committee shall prepare and submit to the Secretary, within 2 months following the last day of each fiscal period, an annual report covering such fiscal...

  13. 11 CFR 2.8 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Annual report. 2.8 Section 2.8 Federal Elections FEDERAL ELECTION COMMISSION SUNSHINE REGULATIONS; MEETINGS § 2.8 Annual report. The Commission shall report annually to Congress regarding its compliance with the requirements of the Government...

  14. 29 CFR 1610.21 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Annual report. 1610.21 Section 1610.21 Labor Regulations... Disclosure Under 5 U.S.C. 552 § 1610.21 Annual report. The Legal Counsel shall, on or before February 1, 1998, and annually thereafter, submit a Freedom of Information Act report covering the preceding fiscal...

  15. 7 CFR 915.32 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Annual report. 915.32 Section 915.32 Agriculture... Regulating Handling Administrative Body § 915.32 Annual report. The committee shall, as soon as practicable after the close of each fiscal year, prepare and mail an annual report to the Secretary, and to...

  16. 36 CFR 901.5 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Annual report. 901.5 Section... CORPORATION § 901.5 Annual report. The Executive Director shall prepare annually a comprehensive and detailed report of the Corporation's operations, activities, and accomplishments for the review of the Board...

  17. 12 CFR 533.7 - Annual reports.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Annual reports. 533.7 Section 533.7 Banks and... AGREEMENTS § 533.7 Annual reports. (a) Applicability date. This section applies only to covered agreements entered into on or after May 12, 2000. (b) Annual report required. Each NGEP and each insured...

  18. 5 CFR 2502.19 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Annual report. 2502.19 Section 2502.19... Reproduction § 2502.19 Annual report. The General Counsel or his or her designee shall annually on or before March 1, submit a Freedom of Information report covering the preceding calendar year to the Speaker...

  19. 7 CFR 916.34 - Annual report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Annual report. 916.34 Section 916.34 Agriculture... Regulating Handling Administrative Body § 916.34 Annual report. The committee shall, as soon as is practicable after the close of each marketing season, prepare and mail an annual report to the Secretary...

  20. 12 CFR 207.7 - Annual reports.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 2 2010-01-01 2010-01-01 false Annual reports. 207.7 Section 207.7 Banks and... OF CRA-RELATED AGREEMENTS (REGULATION G) § 207.7 Annual reports. (a) Applicability date. This section applies only to covered agreements entered into on or after May 12, 2000. (b) Annual report required....