Epidemiology of non-erosive reflux disease.

Non-erosive reflux disease (NERD) is a relatively new entity, the definition of which has been evolving and involves the use of symptoms, endoscopy, and objective evidence of reflux or reflux-related damage. The closest entity to NERD that is examined by available epidemiologic studies is defined by the presence of gastroesophageal reflux disease (GERD) symptoms in the absence of esophageal erosions or Barrett's esophagus. In this review, I identified two population-based studies, one non-community study, and several endoscopy-based studies that provided information on several aspects of NERD.

Hepatitis C infection and risk of diabetes: a systematic review and meta-analysis.

Background/aims: Several studies found hepatitis C (HCV) increases risk of Type II diabetes mellitus (DM). However, others found no or only sub-group specific excess risk. We performed meta-analyses to examine whether HCV infection does increase DM risk in comparison to the general population and in other sub-groups with increased liver disease rates including with hepatitis B (HBV).

Irritable bowel syndrome and dyspepsia among women veterans: prevalence and association with psychological distress.

Background: The burden of functional GI disorders and their associations with psychological distress in women veterans is unclear.

Aim: To examine 1-year prevalence of irritable bowel syndrome (IBS) and dyspepsia symptoms and their associations with anxiety, depression and post-traumatic stress disorder (PTSD) among women veterans receiving primary care at a Veteran Affairs Medical Center Women's Clinic.

Methods: Irritable bowel syndrome, dyspepsia and psychological distress were assessed using the validated self-administered Bowel Disorder Questionnaire, the Beck Depression and Anxiety Inventories, as well as the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorder Questionnaire.

Lagtimes in diagnosis and treatment of colorectal cancer: determinants and association with cancer stage and survival.

Background: Lagtimes to diagnostic colonoscopy have been used as practice performance measures.

Aim: To evaluate the duration, determinants and outcomes of lagtimes between referral for endoscopic evaluation and colorectal cancer (CRC) diagnosis.

Methods: We examined the medical records of 289 patients with CRC and evaluated lagtimes, their potential determinants and their association with CRC stage at diagnosis as well as overall survival.

Hepatitis vaccination in patients with hepatitis C: practice and validation of codes at a large Veterans Administration Medical Centre.

Background: Hepatitis vaccination is recommended in patients with chronic liver disease.

Aim: To validate Current Procedural Terminology (CPT) codes and drug codes for hepatitis vaccination in administrative databases and determine vaccination rates in hepatitis C virus (HCV)-infected patients in a single large Veterans Administration Medical Center.

Methods: We calculated predictive values for hepatitis vaccination codes in a validation set of 168 patients.

Prevalence of endoscopic findings of erosive esophagitis in children: a population-based study.

Purpose: Symptoms of gastroesophageal reflux disease (GERD) occur in 2% to 7% of children. The manifestations of GERD can be limited to symptoms (eg, heartburn, regurgitation) or can be more complicated, such as erosive esophagitis, esophageal strictures, or Barrett esophagus. The prevalence of such GERD complications in children is unknown.

The association between obesity and GERD: a review of the epidemiological evidence.

The current epidemics of obesity and gastroesophageal reflux disease (GERD)-related disorders have generated much interest in studying the association between them. Results of multiple studies indicate that obesity satisfies several criteria for a causal association with GERD and some of its complications, including a generally consistent association with GERD symptoms, erosive esophagitis, and esophageal adenocarcinoma. An increase in GERD symptoms has been shown to occur in individuals who gain weight but continue to have a body mass index (BMI) in the normal range, contributing to the epidemiological evidence for a possible dose-response relationship between BMI and increasing GERD.

Mortality associated with gastroesophageal reflux disease and its non-malignant complications: a systematic review.

Objective: The mortality associated with malignant complications of gastroesophageal reflux disease (GERD) is well recognized. The aim of this systematic review was to assess the less well-examined mortality associated with GERD and its non-malignant complications, including esophageal erosions, ulcers, bleeding, perforation and strictures.

Material And Methods: Studies reporting mortality in GERD and its non-malignant complications were identified via systematic PubMed searches, and previously unpublished population mortality statistics from public access databases.

Diagnosis and treatment of hepatocellular carcinoma.

The diagnosis and treatment of hepatocellular carcinoma (HCC) have witnessed major changes over the past decade. Until the early 1990s, HCC was a relatively rare malignancy, typically diagnosed at an advanced stage in a symptomatic patient, and there were no known effective palliative or therapeutic options. However, the rising incidence of HCC in several regions around the world coupled with emerging evidence for efficacy of screening in high-risk patients, liver transplantation as a curative option in select patients, ability to make definitive diagnosis using high-resolution imaging of the liver, less dependency on obtaining tissue diagnosis, and proven efficacy of transarterial chemoembolization and sorafenib as palliative therapy have improved the outlook for HCC patients.

Prevalence and histological features of the gastric cardia-type mucosa in children.

Background: It has been suggested that the presence of gastric cardia in adults (with or without inflammation or intestinal cells) is a metaplastic condition. The presence of gastric cardia in children would argue against this contention. We examined the presence and determinants of gastric cardia-type mucosa at a normally located z-line in children without underlying gastroesophageal reflux disease (GERD)-predisposing disorders.

The use of acid-decreasing medication in veteran patients with gastro-oesophageal reflux disorder with and without Barrett's oesophagus.

Aim: To examine use of acid-decreasing medications, especially proton pump inhibitors (PPIs), in patients with gastro-oesophageal reflux disorder (GERD) with and without Barrett's oesophagus (BO) in a large-scale study.

Methods: We conducted a retrospective cohort study of patients with newly diagnosed BO (ICD-9 code 5302) and patients with GERD and no BO (ICD-9 53081, 5301) in Department of Veterans Affairs (VA) databases. Filled prescriptions for oral PPI and histamine2-receptor antagonists (H2RA) were identified in the VA Pharmacy Benefit Management database during 365 days following diagnosis.

Role of obesity in GORD-related disorders.

Obesity satisfies several criteria for a causal association with GORD and its complications including generally consistent association and some dose-response relationship. Abdominal obesity seems to explain a considerable part of this association operating mostly by increasing intragastric pressure, gastroesophageal gradient, TLOSR, and oesophageal acid exposure. Additional humoral mechanisms may be important in Barrett's oesophagus and oesophageal adenocarcinoma but this remains poorly examined.

Human immunodeficiency virus-associated squamous cell cancer of the anus: epidemiology and outcomes in the highly active antiretroviral therapy era.

Purpose: To evaluate and determine predictors of squamous cell carcinoma of the anus (SCCA) outcomes in the highly active antiretroviral therapy (HAART) era for HIV-positive and -negative individuals using large national Veterans Affairs (VA) Administration databases.

Patients And Methods: We used the VA administrative databases to perform a retrospective cohort study in 1,184 veterans diagnosed with SCCA between 1998 and 2004. We calculated HIV infection rates and used logistic regression to identify epidemiologic factors that were associated with HIV infection.

Endoscopic and surgical therapy for intrahepatic cholangiocarcinoma in the united states: a population-based study.

Background: Intrahepatic cholangiocarcinoma (ICC) is a highly fatal disease with limited therapeutic options. The determinants, trends, and outcomes of different therapies for ICC are largely unknown in the United States.

Methods: Using data from the Surveillance, Epidemiology, and End-Results-(SEER) Medicare database, we compared ICC patients receiving different therapies between 1992 and 1999.

Views of hepatitis C virus patients delayed from treatment for psychiatric reasons.

For patients with chronic hepatitis C virus, certain psychiatric disorders are contraindications for antiviral therapy with interferon-alpha (IFN). Although these conditions delay a significant portion of patients from beginning therapy, no one has yet portrayed the views of these patients. A qualitative analysis, drawing upon semi-structured interviews, was developed to generate hypotheses regarding patient views of the treatment disposition process, and to generate strategies for increasing the portion of treatment-eligible patients.

Genetic variants of glutathione S-transferase as possible risk factors for hepatocellular carcinoma: a HuGE systematic review and meta-analysis.

The authors performed a systematic review and meta-analysis to determine the effect of polymorphisms in genes encoding glutathione S-transferases (GSTs), phase II isoenzymes involved in cellular detoxification, on risk of hepatocellular carcinoma (HCC). Fifteen eligible studies were identified: 14 evaluated GSTM1; 13, GSTT1; three, GSTP1; and one each evaluated GSTM2, GSTM3, GSTA1, GSTA4, GSTO1, and GSTO2, respectively. All were case-control studies performed in populations with high (Asian, African) and medium (European) HCC incidence rates.

Incidence of esophageal adenocarcinoma in patients with Barrett's esophagus and high-grade dysplasia: a meta-analysis.

Background: Patients with Barrett's esophagus (BE) and high-grade dysplasia (HGD) are at a high risk for developing esophageal adenocarcinoma. However, the reported rate of cancer development in patients with HGD who were undergoing surveillance has varied among published studies.

Objective: To determine an overall precise estimate of cancer incidence in patients with HGD who were undergoing surveillance endoscopy.

Racial disparities in utilization of liver transplantation for hepatocellular carcinoma in the United States, 1998-2002.

Background And Aims: The extent of use of liver transplantation on a population scale to treat hepatocellular carcinoma (HCC) in the United States is unknown. We assessed recent predictors of use of liver transplantation and its effect on survival for those with nonmetastatic HCC.

Methods: The Surveillance, Epidemiology, and End Results (SEER) program is a collection of population-based cancer registries.

The validity of viral hepatitis and chronic liver disease diagnoses in Veterans Affairs administrative databases.

Background: The validity of International Classification of Diseases-9 codes for liver disease has not been determined.

Aim: To examine the accuracy of International Classification of Diseases-9 codes for cirrhosis with hepatitis C virus or alcoholic liver disease and HIV or hepatitis B virus coinfection with hepatitis C virus in Veterans Affairs data.

Methods: We conducted a retrospective study comparing the Veterans Affairs administrative data with abstracted data from the Michael E.

Effect of human immunodeficiency virus and antiretrovirals on outcomes of hepatitis C: a systematic review from an epidemiologic perspective.

Background & Aims: We systematically reviewed the literature examining the association of human immunodeficiency virus (HIV) and antiretroviral therapy (ART) with liver disease in patients with hepatitis C virus (HCV) infection.

Methods: PubMed was searched for studies examining hepatic fibrosis, cirrhosis, decompensated liver disease, hepatocellular carcinoma, and liver-related death. Thirty-nine reports (describing 34 unique studies) met inclusion criteria.