Publications by authors named "Nikki Duong"

Background: Vitamin D deficiency is linked to worse outcomes in patients with chronic liver diseases (CLD). However, data in patients with autoimmune hepatitis (AIH) remain limited.

Aims: We aimed to assess the impact of vitamin D deficiency on the outcomes of individuals with AIH.

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GI fellowships do not mandate curricula in career development. Often, fellows resort to peer mentorship for guidance. Fellows should recognize that the path to a successful career varies greatly based on how one defines and measures success.

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GI fellowships do not mandate curricula in career development. Often, fellows resort to peer mentorship for guidance. Fellows should recognize that the path to a successful career varies greatly based on how one defines and measures success.

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Article Synopsis
  • Metabolic dysfunction-associated steatotic liver disease (MASLD) involves fat accumulation in the liver and issues with metabolism, and growth hormone (GH) therapy is being explored as a treatment option.
  • A systematic review and meta-analysis of randomized controlled trials showed that GH augmentation significantly decreased liver fat levels and improved liver enzyme markers like alanine aminotransferase and gamma-glutamyl transferase.
  • However, it did not significantly affect other health metrics like blood sugar levels or cholesterol, indicating the need for further large-scale studies to explore long-term results and safety.
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The Sustained Alcohol use post-Liver Transplant (SALT) and the High-Risk Alcohol Relapse (HRAR) scores were developed to predict a return to alcohol use after a liver transplant (LT) for alcohol-associated liver disease. A retrospective analysis of deceased donor LT from October 2018 to April 2022 was performed. All patients underwent careful pre-LT psychosocial evaluation.

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  • * Alcohol consumption disrupts gut microbiota, leading to bacterial overgrowth, which may enhance alcohol consumption and worsen alcohol-associated liver disease (ALD).
  • * A review of limited studies shows promise for fecal microbiota transplantation (FMT) as a therapeutic approach to correct alcohol-induced changes in the gut and liver, although more research is needed for conclusive results.
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  • A gastrointestinal variant of Lemierre's syndrome (LS), linked to Fusobacterium species, can lead to serious complications like pylephlebitis and liver abscesses, which are becoming increasingly recognized in medical literature.
  • A systematic review of 36 patients showed that the majority were middle-aged men with symptoms like fever and abdominal pain, and common findings included portal vein thrombosis and liver abscesses.
  • Effective treatment often involves antibiotics, abscess drainage, and long-term anticoagulation, with no reported deaths in the studied cases, emphasizing the importance of timely diagnosis and management.
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  • The COVID-19 pandemic has heightened the impact of gastrointestinal diseases (GID), increasing the severity and mortality rates among patients in the U.S.
  • A study analyzing data from January 2020 to December 2022 found that out of nearly 10 million deaths, a small percentage were directly related to both COVID-19 and GID, with significant differences in age and race affecting mortality rates.
  • Results indicated that Hispanic individuals faced the highest age-adjusted mortality rates for both conditions, highlighting the need for further investigation into these disparities to promote equitable health outcomes.
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  • Gastroenterology has become a competitive subspecialty in internal medicine, especially during the recent fellowship match period affected by the COVID-19 pandemic.
  • An analysis of National Resident Matching Program data from 2010-2022 revealed significant growth in both fellowship positions and applicants for gastroenterology.
  • The findings suggest the need for more positions in gastroenterology to address competition and potential shortages, while also indicating a positive correlation between fellowship competitiveness and compensation across specialties.
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Background: The career trajectory of medical professionals, particularly in specialized fields like gastroenterology, can significantly impact healthcare and research. This study aimed to analyze career choices among gastroenterology fellows in the US and investigate the factors influencing these choices.

Methods: We utilized data from the American Medical Association on internal medicine subspecialty fellows.

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The number of people who report to be of minoritised sexual or gender identities in the USA, including lesbian, gay, bisexual, transgender, queer, and other sexuality-diverse and gender-diverse identities, has been increasing in the past decade. This diverse and unique population continues to experience not only health disparities but also psychosocial, economic, and legal disparities in accessing and receiving health care, including liver transplantations. As liver transplantation is life-saving for people with end-stage liver disease, understanding the factors that can affect access to and quality of liver transplantation care in people of minoritised sexual and gender identities in the USA, including differential social supports, insurance coverage, and medical and psychiatric comorbidities, is crucial.

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Background & Aims: Hepatorenal syndrome (HRS) can occur in patients with cirrhosis and ascites due to splanchnic vasodilation, renal hypoperfusion, and vasoconstriction. HRS is a diagnosis of exclusion and portends a poor prognosis, with upward of 80% mortality at 2 weeks without treatment. This review will highlight randomized controlled trials for HRS pharmacotherapy.

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The coronavirus disease 2019 (COVID-19) pandemic presented unique challenges to patients with decompensated cirrhosis awaiting transplant, with respect to accessing medical facilities for routine clinic visits, imaging, laboratory workup, or endoscopies. There was a delay in organ procurement that led to a decrease in the number of liver transplants (LTs) and an increase in the morality of waitlisted patients at the beginning of the pandemic. LT numbers later equalized to pre-pandemic numbers due to combined efforts and adaptability of transplant centers as well as dynamic guidelines.

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Background/aims: Non-alcoholic fatty liver disease (NAFLD) is frequent in people living with HIV (PLWH) and may be aggravated by metabolic comorbidities and antiretroviral therapy (ART)-associated adverse effects.

Methods: We retrospectively assessed epidemiological, clinical and laboratory parameters and ART regimens at HIV diagnosis (BL) and at last follow-up (FU) in 1458 PLWH without viral hepatitis coinfection attending our HIV clinic in 2014-2016. Fibrosis was non-invasively assessed by the NAFLD fibrosis score (NFS).

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Aortic stenosis (AS) is the most common valvular disease and is reported to be present in 2%-7% of people over the age of 65. Risk factors for aortic stenosis and NASH overlap; thus, as the population ages, there is an increased likelihood that patients undergoing liver transplantation evaluation may have severe aortic stenosis. There is a high mortality rate associated with cardiac surgeries in patients with cirrhosis.

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Background: Transjugular intrahepatic portosystemic shunt (TIPS) is used to treat complications of portal hypertension, such as ascites and variceal bleeding (VB). While liver doppler ultrasound (DUS) is used to assess TIPS patency, trans-shunt venography (TSV) is the gold standard.

Aim: To determine the accuracy of DUS to assess TIPS dysfunction and for need for revision.

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Nosocomial infections (NIs) in critically ill patients with cirrhosis result in higher death and transplant delisting. NIs are promoted by staff, visitors, and the environment, all of which were altered to reduce pathogen transmission after COVID-19. Two cohorts of intensive care unit patients with cirrhosis from March 2019 to February 2020 (pre-COVID, n = 234) and March 2020 to March 2021 (COVID era, n = 296) were included.

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