Heartburn Center Set-Up in a Community Setting: Engineering and Execution.

Optimal management of gastroesophageal reflux disease (GERD) requires a concerted team of physicians rather than an individual approach. While an integrated approach to GERD has previously been proposed, the practical execution of such a "center of excellence" (COE) has not been described, particularly in a community setting. Ranging from initial consultation and diagnosis to surgical intervention for complex disease, such an approach is likely to provide optimal care and provide surveillance for patients with a complex disease process of GERD.

Comparison of indocyanine green clearance with Child's-Pugh score and hepatic histology: a multivariate analysis.

Background/aims: Indocyanine green clearance, measured by percentage disappearance rate, detects alterations in liver function and may be used as a non-invasive determinant of hepatic reserve. The aims of this study were to compare liver histology and Child's-Pugh score with percentage disappearance rate and determine which variables correlated with PDR.

Methodology: Child's-Pugh score, liver function tests, liver biopsies and indocyanine green testing (0.