Pediatrics Armstrong, S. et. al.
Oct 27th, 2019 - Severe obesity among youth is an “epidemic within an epidemic” and portends a shortened life expectancy for today’s children compared with those of their parents’ generation. Severe obesity has outpaced less severe forms of childhood obesity in prevalence, and it disproportionately affects adolescents. Emerging evidence has linked severe obesity to the development and progression of multiple co...
Current Opinion in Clinical Nutrition & Metabolic Care; Contaldo, F. et. al.
Jun 17th, 2019 - Purpose of review To review the healthy protective effects of coffee against several metabolic diseases and some types of cancer. In this short review, the possible preventive and/or therapeutic actions of coffee on liver function is focused. Recent findings The protective mechanisms of coffee are various and because of several components with anti-inflammatory and antioxidant properties in ...
May 9th, 2019 - On May 10, 2019, the Food and Drug Administration approved ramucirumab (CYRAMZA®, Eli Lilly and Company) as a single agent for hepatocellular carcinoma (HCC) in patients who have an alpha fetoprotein (AFP) of ≥ 400 ng/mL and have been previously treated with sorafenib.
Benson, A. et. al.
Mar 31st, 2019 - Incidence and mortality rates for cancer overall are declining, but both incidence and mortality rates for hepatocellular carcinoma (HCC) are increasing.1,2 Risk factors for development of HCC include infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV), and cirrhosis of the liver (eg, alcohol cirrhosis).3 Metabolic disorders (ie, obesity, diabetes, impaired glucose metabolism,...
Feb 21st, 2019 - Appendicitis is inflammation of the vermiform appendix. This is a hollow organ located at the tip of the cecum, usually in the right lower quadrant of the abdomen.
Sharma, B. et. al.
Jan 31st, 2019 - Nonalcoholic, fatty liver disease (NAFLD) is defined as the ectopic accumulation of fat in the liver (hepatic steatosis) when no other causes of secondary, liver fat accumulation are present. As minor deposition of fat can occur in healthy adults, deposition of fat in at least 5% of hepatocytes is considered pathologic. Nonalcoholic steatohepatitis (NASH) is diagnosed via a liver biopsy when th...
Jan 22nd, 2019 - The landscape of systemic therapy of hepatocellular carcinoma (HCC) has dramatically changed in the last 5 years with the introduction of various active agents into clinical pathways. The latest addition of agents with proof-of-efficacy in HCC is ramucirumab, an antibody against VEGF-R2. The published results of the REACH-2 trial in patients with prior sorafenib therapy demonstrate increased ov...
Zhu, A. et. al.
Jan 17th, 2019 - Patients with advanced hepatocellular carcinoma and increased α-fetoprotein concentrations have poor prognosis. We aimed to establish the efficacy of ramucirumab in patients with advanced hepatocellular carcinoma and α-fetoprotein concentrations of 400 ng/mL or higher.
Singal, A. et. al.
Jan 16th, 2019 - Background & Aims There is controversy over the effects of direct-acting antiviral (DAA) therapies for hepatitis C (HCV) infection on hepatocellular carcinoma (HCC) recurrence and tumor aggressiveness. We compared HCC recurrence patterns between DAA-treated and untreated HCV-infected patients who had achieved a complete response to HCC treatment in a North American cohort.
Nov 30th, 2018 - Appendicitis is acute inflammation of the vermiform appendix, typically resulting in abdominal pain, anorexia, and abdominal tenderness. Diagnosis is clinical, often supplemented by CT or ultrasonography. Treatment is surgical removal of the appendix
Sep 30th, 2018 - The American Society of Colon and Rectal Surgeons (ASCRS) is dedicated to ensuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Clinical Practice Guidelines Committee is charged with leading international efforts in defining quality care for conditions related to the colon, rectum, and anus by develo.
American Urological Association
Sep 30th, 2018 - Computer assisted surgery using remote tele-presence manipulators is widely referred to as robot assisted or robotic surgery. Since the term is used extensively in the press as well as medical journals, the term “robotic surgery” will be used in this document.
Jul 31st, 2018 - The American Society for Metabolic and Bariatric Surgery (ASMBS) issued a position statement on the role of bariatric surgery in class I obesity in 2012 . That statement was developed in response to inquiries made to the ASMBS by society members, physicians, patients, hospitals, health insurance payers, policymakers, and the media regarding the safety and efficacy of bariatric surgery f...
Jul 31st, 2018 - This guidance provides a data‐supported approach to the diagnosis, staging, and treatment of patients diagnosed with hepatocellular carcinoma (HCC). A guidance document is different from a guideline.
American Cleft Palate–Craniofacial Association (ACPA)
Dec 31st, 2017 - Purpose: identifying recommended practices in the care of patients with craniofacial differences. This document is divided into the following sections: (1) interdisciplinary teams: composition, qualifications of team members, and general responsibilities of teams, (2) contemporary practices of the team during the early months of life of the patient, and (3) longitudinal evaluation and treatmen.
Oct 31st, 2017 - Rectal prolapse is a disorder characterized by a full-thickness intussusception of the rectal wall, which protrudes externally through the anus. It is associated with a spectrum of coexisting anatomic abnormalities, such as diastasis of the levator ani, an abnormally deep cul-de-sac, a redundant sigmoid colon, a patulous anal sphincter, and loss or attenuation of the rectal sacral attachments.
Apr 30th, 2017 - Mesenteric vascular insufficiency is a serious medical condition that may lead to bowel infarction, morbidity, and mortality that may approach 50%. Recommended therapy for acute mesenteric ischemia includes aspiration embolectomy, transcatheter thrombolysis, and angioplasty with or without stenting for the treatment of underlying arterial stenosis.
Apr 30th, 2017 - Because liver fibrosis can be treated, it is important to diagnose liver fibrosis noninvasively and monitor response to treatment. Although ultrasound (grayscale and Doppler) can diagnose cirrhosis, it does so unreliably using morphologic and sonographic features and cannot diagnose the earlier, treatable stages of hepatic fibrosis.
Ira M. Jacobson
Apr 30th, 2017 - Chronic hepatitis C virus infection is well-recognized as a common blood-borne infection with global public health impact affecting 3 to 5 million persons in the United States and more than 170 million persons worldwide. Chronic hepatitis C virus infection is associated with significant morbidity and mortality due to complications of liver cirrhosis and hepatocellular carcinoma.
David B. Stewart Sr.
Jan 5th, 2017 - The term anal fissure most commonly refers to a longitudinal tear within the anal canal, one that typically extends from the dentate line toward the anal verge. This benign anorectal ailment is quite common, although there have been virtually no published population-level data describing its incidence.
Seth R. Schwartz
Jan 2nd, 2017 - The primary purpose of this guideline is to help clinicians identify patients with cerumen impaction who may benefit from intervention and to promote evidence-based management. Another purpose of the guideline is to highlight needs and management options in special populations or in patients who have modifying factors.
Siddharth A. Padia, MD et. al.
Dec 31st, 2016 - This document serves as a guide on hepatic artery radioembolization for the treatment of primary and secondary liver malignancies.
Jon D. Vogel
Dec 14th, 2016 - A generally accepted explanation for the etiology of anorectal abscess and fistula-in-ano is that the abscess results from obstruction of an anal gland and the fistula is due to chronic infection and epithelialization of the abscess drainage tract. Anorectal abscesses are defined by the anatomic space in which they develop and are more common in the perianal and ischiorectal spaces and less com.
Dec 1st, 2016 - Background: The management of patients with enterocutaneous fistula (ECF) requires an interdisciplinary approach and poses a significant challenge to physicians, wound/stoma care specialists, dietitians, pharmacists, and other nutrition clinicians. Guidelines for optimizing nutrition status in these patients are often vague, based on limited and dated clinical studies, and typically rely on ind.
Ron C. Gaba, MD et. al.
Mar 31st, 2016 - The present independent review, revision, and ratification of the previous report by the Society of Interventional Radiology (SIR) Interventional Oncology Service Line and Techno logy Assessment Committee (1,2) represents a continuation of the collaborative initiative to consolidate and unite all investigators and clinicians practicing interventional oncology by providing a common language to d.
The National Craniofacial Association
Feb 24th, 2016 - Description of cleft lip and cleft palate aimed at helping parents understand the conditions and the surgeries that may be required. Provides list of additional resources.
Richard G. Barr
Jun 15th, 2015 - Chronic liver disease is a substantial worldwide problem. Its major consequence is increasing deposition of fibrous tissue within the liver, leading to the development of cirrhosis with its consequences, portal hypertension, hepatic insufficiency, and hepatocellular carcinoma (HCC).
Mar 2nd, 2015 - The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations based on the comparative effectiveness of risk assessment scales and preventive interventions for pressure ulcers.
Mar 2nd, 2015 - The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations based on the comparative effectiveness of treatments of pressure ulcers.
John A. Evans
Feb 26th, 2015 - This document is an update of the 2008 publication entitled “The Role of Endoscopy in the Bariatric Surgery Patient. ”2 The purpose of this document is to update endoscopists on the utility of endoscopy in the management of patients considering bariatric surgery and those who have undergone a bariatric procedure.
Jul 31st, 2014 - Guidelines present a synthesis of evidence-based recommendations for the diagnosis and treatment of a specific medical condition. The value of a guideline is that it provides consistency among treatment protocols given to patients, resulting in improved efficacy and the quality of care and reduced cost.
Jul 14th, 2014 - These guidelines summarize the definitions, diagnostic criteria, differential diagnoses, and treatments of a group of benign disorders of anorectal function and/or structure. Disorders of function include defecation disorders, fecal incontinence, and proctalgia syndromes, whereas disorders of structure include anal fissure and hemorrhoids.
Scott R. Steele
Feb 28th, 2014 - Pilonidal disease is a potentially debilitating condition affecting 70,000 patients annually in the United States alone. Although commonly encountered in practice, the cause and optimal treatment of this disease have remained controversial since its first description by Mayo in 1833.
Jeffrey I. Mechanick
Mar 25th, 2013 - Obesity continues to be a major public health problem in the United States, with more than one-third of adults considered obese in 2009-2010, as defined by a body mass index (BMI) ?30 kg/m2 (1 [EL 3, SS]). Obesity has been associated with an increased hazard ratio for all-cause mortality (2 [EL 3, SS]), as well as significant medical and psychological co-morbidity.
JAMA Jakobsen GS, Småstuen MC et. al.
Jan 17th, 2018 - The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Cohort study with baseline data of exposures from Novem...
William S. Richardson
May 31st, 2012 - The goals of ventral hernia repair are relief of patient symptoms and/or cure of the hernia with minimization of recurrence rates. While laparoscopic ventral hernia repair (LVHR) has gained popularity in recent years, there is still significant controversy about the optimal approach to ventral hernia repair.
Obstetrics and Gynecology; Menke MN, King WC et. al.
Oct 10th, 2017 - To examine contraceptive practices and conception rates after bariatric surgery. The Longitudinal Assessment of Bariatric Surgery-2 is a multicenter, prospective cohort study of adults undergoing first-time bariatric surgery as part of routine clinical care at 10 U.S. hospitals. Recruitment occurred between 2005 and 2009. Participants completed preoperative and annual postsurgical assessments f...
Daniel B. Brown
Feb 29th, 2012 - These guidelines are written to be used in quality improvement programs to assess chemoembolization. The most important processes of care are (i) patient selection, (ii) performing the procedure, and (iii) monitoring the patient.
Obstetrics and Gynecology; Stuart A, Källen K
Apr 6th, 2017 - To compare the rates of abdominal surgery during pregnancy among women with previous bariatric surgery (women in the case group) and women with first-trimester body mass index (BMI) greater than 35 and no previous bariatric surgery (women in the control group). We conducted a national cohort study, merging data from the Swedish Medical Birth Registry and the Swedish National Patient Registry, c...
Gastroenterology Serper M, Taddei TH et. al.
Mar 11th, 2017 - Little is known about provider and health system factors that affect receipt of active therapy and outcomes of patients with hepatocellular carcinoma (HCC). We investigated patient, provider, and health system factors associated with receipt of active HCC therapy and overall survival. We performed a national, retrospective cohort study of all patients diagnosed with HCC from January 1, 2008 thr...
Journal of Hepatology; Sapisochin G, Barry A et. al.
Mar 4th, 2017 - There is limited information on the use of stereotactic body radiotherapy (SBRT) as a bridge to liver transplantation for hepatocellular carcinoma and no study comparing its efficacy to transarterial chemoembolization (TACE) and radiofrequency ablation (RFA). We aimed to ascertain the safety and efficacy of SBRT on an intention-to-treat basis compared with TACE and RFA as a bridge to liver tran...
The Lancet. Diabetes & Endocrinology; Inge TH, Jenkins TM et. al.
Jan 9th, 2017 - Little is known about the long-term outcomes of bariatric surgery for severe adolescent obesity, raising questions about the durability of early responses to surgery. We aimed to analyse long-term (>5 years) outcomes of Roux-en-Y gastric bypass in a cohort of young adults who had undergone the operation during adolescence, in the Follow-up of Adolescent Bariatric Surgery at 5 Plus Years (FABS-5...
Feb 28th, 2011 - Radioembolization is a field of interventional oncology that continues to evolve. The vehicle of a standards document provides the framework for reporting various aspects of the technique, including classification of methodology, descriptors of toxicities and complications, imaging guidance, and appropriate terminology that require specific attention when reporting clinical studies.
JAMA Pediatrics; Ryder JR, Edwards NM et. al.
Jul 18th, 2016 - Severe obesity is associated with mobility limitations and higher incidence of multijoint musculoskeletal pain. It is unknown whether substantial weight loss improves these important outcomes in adolescents with severe obesity. To examine the association of bariatric surgery with functional mobility and musculoskeletal pain in adolescents with severe obesity up to 2 years after surgery. The Tee...
Obstetrics and Gynecology; Vannevel V, Jans G et. al.
May 9th, 2016 - To assess maternal and fetal outcomes of pregnancies complicated by internal herniation after Roux-en-Y gastric bypass. Articles were identified through searches in online databases (ClinicalTrials.gov, MEDLINE, EMBASE, PubMed, and Google Scholar) from January 1980 to March 2015 for the following terms: [gastric bypass OR bariatric surgery] AND [pregnancy] AND [complication OR herniation OR obs...
JAMA King WC, Chen JY et. al.
Apr 5th, 2016 - The variability and durability of improvements in pain and physical function following Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB) are not well described. To report changes in pain and physical function in the first 3 years following bariatric surgery, and to identify factors associated with improvement. The Longitudinal Assessment of Bariatric Surgery-2 is...
Hepatology (Baltimore, Md.); El-Serag HB, Kanwal F et. al.
Mar 7th, 2016 - The long-term prognosis in terms of risk or predictors of developing hepatocellular carcinoma (HCC) among patients with sustained virological response (SVR) remains unclear. We conducted a retrospective cohort study using data from the Veterans Affairs VA hepatitis C virus (HCV) Clinical Case Registry in patients with positive HCV RNA between October 1999 and August 2009 and follow-up through D...
JAMA Dawes AJ, Maggard-Gibbons M et. al.
Jan 12th, 2016 - Bariatric surgery is associated with sustained weight loss and improved physical health status for severely obese individuals. Mental health conditions may be common among patients seeking bariatric surgery; however, the prevalence of these conditions and whether they are associated with postoperative outcomes remains unknown. To determine the prevalence of mental health conditions among bariat...
The New England Journal of Medicine; Inge TH, Courcoulas AP et. al.
Nov 6th, 2015 - Bariatric surgery is increasingly considered for the treatment of adolescents with severe obesity, but few prospective adolescent-specific studies examining the efficacy and safety of weight-loss surgery are available to support clinical decision making. We prospectively enrolled 242 adolescents undergoing weight-loss surgery at five U.S. centers. Patients undergoing Roux-en-Y gastric bypass (1...
The Lancet. Oncology; Bruix J, Takayama T et. al.
Sep 12th, 2015 - There is no standard of care for adjuvant therapy for patients with hepatocellular carcinoma. This trial was designed to assess the efficacy and safety of sorafenib versus placebo as adjuvant therapy in patients with hepatocellular carcinoma after surgical resection or local ablation. We undertook this phase 3, double-blind, placebo-controlled study of patients with hepatocellular carcinoma wit...