Effectiveness of multidisciplinary approach in patients undergoing therapy for chronic hepatitis C.

Objective: To assess the effect of a multidisciplinary approach on the outcome of treatment for hepatitis C virus infection.

Methods: This retrospective study was conducted at the gastroenterology division by primary care providers at Phoenix VA Healthcare system in Phoenix, Arizona, United States, and comprised clinical and laboratory data of all hepatitis C patients treated between November 2002 and December 2006. The patients were clinically evaluated to determine whether they were candidates for treatment with pegylated interferon a-2a or a-2b plus ribavirin.

String capsule endoscopy for screening and surveillance of esophageal varices in patients with cirrhosis.

Background: EGD is the gold standard for the screening and surveillance of esophageal varices. A less invasive, safer and sedationless alternative procedure is needed.

Objective: To assess the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) as well as the beyond the chance agreement (kappa index), of string capsule endoscopy (SCE) in the diagnosis of esophageal varices.

The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner.

Due to time constraints, fewer physicians are performing large volume paracentesis (LVP) resulting in a longer wait time and more emergency department (ED) and hospital admissions. At our institution, after initial supervision, a certified nurse practitioner (NP) has independently performed LVP in a dedicated cirrhosis clinic. The purpose of our study was to evaluate the feasibility and safety of LVP performed by a NP.

Spontaneous regression of hepatocellular carcinoma is possible and might have implications for future therapies.

Hepatocellular carcinoma is a potentially challenging cancer with very high mortality. Medical therapies are generally ineffective in achieving complete remission, especially for aggressive types or for advanced stage cancers. Spontaneous regression of these tumors is a rare and fascinating phenomenon.

Feasibility and safety of string wireless capsule endoscopy in the diagnosis of esophageal varices.

Objective: To assess the feasibility, safety, accuracy, and acceptability of "string-capsule endoscopy" in the evaluation of esophageal varices.

Material And Methods: Strings were attached to the wireless capsule endoscopy device to allow its controlled movement up and down the esophagus. Time of recording and discomfort associated with the procedure was documented.