Differences in Referral Access to Care Between Gastrointestinal Subspecialty Patients: Barriers and Opportunities.

Referral access to subspecialty care for patients with gastrointestinal (GI) diseases is not well defined, but has significant importance to patients. We hypothesized that patients experience barriers to care in two common gastroenterology subspecialties, Hepatology and Motility, in a university medical center. Two hundred thirteen clinic patients (mean age 46.

Performance characteristic of endoscopic ultrasound-guided fine needle aspiration is unaffected by pancreatic mass size.

Background And Study Aims: Despite a well-established tool for diagnosis of pancreatic masses, endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) studies have shown suboptimal diagnostic performance at divergent mass sizes. Since the impact of gold standard follow-up and presence of on-site evaluation on this observation is unknown, we aimed to study the performance characteristics of EUS-FNA under these strict conditions.

Patients And Methods: EUS-FNA results from pancreatic mass lesions performed between July 2000 and March 2013 were evaluated.

Serum catecholamines and dysautonomia in diabetic gastroparesis and liver cirrhosis.

Background: Plasma catecholamine influences autonomic function and control, but there are few reports correlating them. In this study, 47 individuals (mean age, 38 years) were studied: 19 diabetes mellitus (DM) patients with gastroparesis, 16 with liver disease and 12 control subjects.

Methods: Noninvasive autonomic function was assessed for sympathetic adrenergic functions as peripheral vasoconstriction in response to cold stress test and postural adjustment ratio (PAR) and cholinergic function as Valsalva ratio, represented by change in R-R intervals.

Impact of pancreatic stent caliber on post-endoscopic retrograde cholangiopancreatogram pancreatitis rates in patients with confirmed sphincter of Oddi dysfunction.

Background: Despite proven clinical benefit, there are no studies that have examined the relationship between pancreatic stent caliber and its impact on PEP [post-endoscopic retrograde cholangiopancreatogram (ERCP) pancreatitis] in high-risk patients.

Aim: To study the relationship between stent caliber and PEP rates in patients with confirmed sphincter of Oddi dysfunction (SOD).

Methods: A retrospective review was conducted of ERCP's in patients with SOD from 2002 to 2012 from a prospectively maintained, Institutional Review Board approved database.