COMPASS: A Pilot Trial of an Early Palliative Care Intervention for Patients With End-Stage Liver Disease.

Context: Palliative care interventions have shown promise in improving quality of life and reducing health-care utilization among patients with chronic organ failure.

Objectives: To evaluate the effect of a palliative care intervention for adults with end-stage liver disease.

Methods: A randomized controlled trial of patients with end-stage liver disease admitted to the hepatology service at a tertiary referral center whose attending hepatologist indicated they would not be surprised if the patient died in the following year on a standardized questionnaire was performed.

Early outcomes using hepatitis C-positive donors for cardiac transplantation in the era of effective direct-acting anti-viral therapies.

Background: Given the shortage of suitable donor hearts for cardiac transplantation, and the favorable safety and efficacy of current agents used to treat hepatitis C virus (HCV), our institution recently piloted transplantation of select patients using HCV-positive donors.

Methods: Between September 2016 and March 2017, 12 HCV-naive patients and 1 patient with a history of treated HCV underwent heart transplantation (HT) using hearts from HCV-positive donors after informed consent. Patients who acquired HCV were referred to hepatology and treated with direct-acting anti-viral therapies (DAAs).

Age-accelerated psychomotor slowing in temporal lobe epilepsy.

Cognitive and psychomotor slowing is a complication of epilepsy and is less often a focus of investigation relative to other cognitive domains (e.g., memory).

Acoustic liver biopsy in patients with hepatitis C and advanced liver fibrosis using endoscopic ultrasound.

Background: Transabdominal ultrasound cannot be used to quantitate fibrosis in patients with advanced liver fibrosis due to variability in the abdominal wall thickness and composition. This variability can be eliminated by using endoscopic ultrasound.

Aim: The purpose of this study was to determine the amount of fibrosis in the liver of hepatitis C patients with advanced fibrosis using endoscopic ultrasound.

Minimally invasive measurement of esophageal variceal pressure and wall tension (with video).

Background: There is no simple method to measure intravariceal pressure in patients with esophageal varices.

Objective: Our purpose was to develop a new noninvasive technique to measure resting intravariceal pressure and wall tension.

Design: A model was developed.

Muscle shortening along the normal esophagus during swallowing.

Longitudinal shortening of the esophagus during peristaltic contraction has been previously analyzed globally using spaced mucosal clips. This method gives a relatively crude measurement. In this study, local longitudinal shortening (LLS) was evaluated using simultaneous high-resolution endoluminal ultrasound (HREUS) and manometry based on basic principles of muscle mechanics.

Simplified method of hepatic fibrosis quantification: design of a new morphometric analysis application.

Introduction: Semiquantitative evaluation of liver specimens is considered the standard method for measuring fibrosis; however, these systems lack the precision of a quantitative technique.

Methods: We developed an image analysis application (FibroXact) that automates and simplifies color segmentation. Trichrome slides were scanned and the program was used to evaluate each pixel based upon hue, lightness, and saturation values.

A new ultrasound-guided esophageal variceal pressure-measuring device.

Objective: To develop a noninvasive method and device to determine intravariceal pressure and variceal wall tension by measuring the variables of the Laplace equation and test this device in a model of esophageal varices.

Methods: Two variceal pressure measurement devices were constructed. The first device consists of an Olympus 20 MHz ultrasound transducer placed next to a latex balloon catheter attached to a pressure transducer.