Association of serum bilirubin with aging and mortality.

Background And Aims: Bilirubin, a breakdown product of heme metabolism, has been shown to be protective against cardiovascular mortality; however, it is also a marker of liver function. There are limited data on the longitudinal changes in bilirubin with aging in a population-based cohort of older adults. This study was designed to determine whether serum bilirubin changes with age in older adults, and to evaluate whether age attenuates the association between bilirubin and mortality.

Serum levels of alanine aminotransferase decrease with age in longitudinal analysis.

Background & Aims: An increased level of alanine aminotransferase (ALT) is a marker of liver injury. The mean ALT level has been reported to decrease with age; we performed a longitudinal analysis to determine whether serum levels of ALT changes with age among community-dwelling, older adults in the US.

Methods: We analyzed clinical data from 2 cohorts of individuals who participated in the Rancho Bernardo Study, in Southern CA.

Missed work related to mid-week screening colonoscopy.

Background: Most screening colonoscopies require patients to miss work on the day of the procedure. Little is known about whether patients are taking additional time off from work, and the reasons for doing so.

Aims: The purpose of this study was to assess the patterns and reasons for missed work related to screening colonoscopies.

Alanine aminotransferase decreases with age: the Rancho Bernardo Study.

Background: Serum alanine aminotransferase (ALT) is a marker of liver injury. The 2005 American Gastroenterology Association Future Trends Committee report states that serum ALT levels remain constant with age. This study examines the association between serum ALT and age in a community-dwelling cohort in the United States.

Insulin sensitizers in nonalcoholic fatty liver disease and steatohepatitis: Current status.

Nonalcoholic fatty liver disease (NAFLD), first described in 1980, is now recognized as one of the most common causes of elevated liver enzymes and chronic liver disease in Western countries. The incidence of NAFLD in both adults and children is rising, in conjunction with the burgeoning epidemics of obesity and type 2 diabetes mellitus. NAFLD often coexists with other sequelae of the metabolic syndrome: central obesity, type 2 diabetes, hypertension, and hyperlipidemia.

Hepatitis B prophylaxis in patients undergoing chemotherapy for lymphoma: a decision analysis model.

Unlabelled: Hepatitis B reactivation is a major cause of morbidity and mortality in patients undergoing chemotherapy for lymphomas. These patients may experience direct liver-related complications or reduced cancer survival because of interruptions in chemotherapy. Our aim was to compare the costs and outcomes of 2 different chronic hepatitis B management strategies.

Evaluation of a pharmacist-managed hepatitis C care clinic.

Purpose: A description of an effort to create a more time, labor, and cost-efficient method for the management of patients with hepatitis C virus (HCV) infection in Department of Veterans Affairs (VA) hospitals is provided; this pilot study also revealed the outcomes of a pharmacist-managed clinic for these patients in comparison to established standards of care.

Methods: A retrospective analysis was performed on data obtained from patients who were referred to the clinic between October 2002 and March 2004 and who had a clinical pharmacist as their primary treatment provider. The patients' medical records were searched for demographic information, disease characteristics, treatment information, treatment and safety information, and virological response.

Gastroduodenal mucosal defense.

Purpose Of Review: The duodenum absorbs nearly all secreted gastric acid. Carbonic anhydrases facilitate transmucosal acid movement. The upper gastrointestinal tract must resist a variety of injuries, including those caused by ingested noxious substances, acid, ischemia/reperfusion, and infections such as Helicobacter pylori.