Patel Variceal bleeding as a complication of portal hypertension results in significant mortality and morbidity in patients with cirrhosis. Limited data exists on compliance with practice guidelines that recommend screening esophagogastroduodenoscopy (EGD) in cirrhotic patients for gastroesophageal varices. Aim: To provide cross-sectional comparison of screening practices and outcomes
in patients with cirrhosis. Methods: selleck inhibitor Explorys database for 1999-2014 was queried for ICD-9 codes related to adult patients with cirrhosis. This database contains over 40 million unique patient records consisting of 310 hospitals across the United States. Patients were stratified into two groups (alcohol and non-alcohol related cirrhosis). EGDs were queried by procedure code and were defined as at least one EGD per patient. Time between diagnosis of cirrhosis and EGD were evaluated and trends assessed. Primary outcome was the number of patients
who had at least one EGD. Variceal bleeding was queried by ICD-9 codes within the same group of patients. Results: A total of 131,130 patients with cirrhosis were evaluated. Of the total EGDs performed, 39% were in patients with alcohol related cirrhosis versus 61% in non-alcoholic cirrhosis patients. Overall only 23% of patients received an EGD after the diagnosis of cirrhosis. Of these, 39% were performed in the first month after diagnosis and 73% in one year. Of the total variceal bleeds for 1 year 43% occurred within the first 15 days and 52% occurred within 30 days of diagnosis. Fer-1 nmr Conclusion: The rate of compliance for variceal screening was low in cirrhotics. Rates of EGD in cirrhotic patients appear sub-optimal
even 1 year after diagnosis. Adequate screening and treatment of varices in cirrhotics could decrease the incidence of variceal bleeding in these patients. Disclosures: The following people have nothing to disclose: Abhijeet Waghray, Nisheet Waghray, learn more Annette Kyprianou, KV Narayanan Menon “
“The carcinoid syndrome develops in patients with metastatic disease from a serotonin-producing endocrine tumor in the small intestine. It includes facial flushing, diarrhea, right-sided heart failure because of valvular disease, and bronchial constriction. The diagnostic work-up includesimaging, somatostatin receptor scintigraphy, measurement of biochemical markers (U-5HIAA and chromogranin A) and immunohistochemical examination of a tumor specimen. Treatment options include surgery, radiofrequency ablation, liver embolization, alpha-interferon, and somatostatin analogs. Tumor targeting treatment with radiolabeled somatostatin analogs has recently been included in the therapeutic arsenal. Because of the slow-growing nature of the tumor and successful medical therapy, the 5-year survival is about 60% despite metastatic disease at diagnosis. “
“Background. Hepatic stellate cell (HSC) activation plays a pivotal role in liver fibrosis and disease progression in nonalcoholic fatty liver disease (NAFLD).
No related posts.