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February 2010 Vol. 8, No. 2

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Endoscopy Corner

Incidence of Sedation-Related Complications With Propofol Use During Advanced Endoscopic Procedures

Gregory A. Coté, Robert M. Hovis, Michael A. Ansstas, Lawrence Waldbaum, Riad R. Azar, Dayna S. Early, Steven A. Edmundowicz, Daniel K. Mullady, Sreenivasa S. Jonnalagadda

Propofol is an effective sedative in advanced endoscopy. However, the incidence of sedation-related complications is unclear. We sought to define the frequency of sedation-related adverse events, particularly the rate of airway modifications (AMs), with propofol use during advanced endoscopy. We also evaluated independent predictors of AMs.


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Issue Highlights

Perspective

Symptoms and Tests for Irritable Bowel Syndrome: Diagnosing a Complex Disorder

George F. Longstreth

Original Articles—Alimentary Tract

Algorithms Outperform Metabolite Tests in Predicting Response of Patients With Inflammatory Bowel Disease to Thiopurines

Akbar K. Waljee, Joel C. Joyce, Sijian Wang, Aditi Saxena, Margaret Hart, Ji Zhu, Peter D.R. Higgins

Serious Complications Within 30 Days of Screening and Surveillance Colonoscopy Are Uncommon

Cynthia W. Ko, Stacy Riffle, Leann Michaels, Cynthia Morris, Jennifer Holub, Jean A. Shapiro, Marcia A. Ciol, Michael B. Kimmey, Laura C. Seeff, David Lieberman

Effects of Chenodeoxycholate and a Bile Acid Sequestrant, Colesevelam, on Intestinal Transit and Bowel Function

Suwebatu T. Odunsi–Shiyanbade, Michael Camilleri, Sanna McKinzie, Duane Burton, Paula Carlson, Irene A. Busciglio, Jesse Lamsam, Ravinder Singh, Alan R. Zinsmeister

Original Articles—Liver, Pancreas, and Biliary Tract

Antiviral Therapy Reduces Risk of Hepatocellular Carcinoma in Patients With Hepatitis C Virus–Related Cirrhosis

Ashwani K. Singal, Amanpal Singh, Sathya Jaganmohan, Praveen Guturu, Rajasekhara Mummadi, Yong–Fang Kuo, Gagan K. Sood

Survival and Recurrence in Patients With Splanchnic Vein Thromboses

Mallikarjun R. Thatipelli, Robert D. McBane, David O. Hodge, Waldemar E. Wysokinski

Prevalence and Factors Associated With Liver Test Abnormalities Among Human Immunodeficiency Virus–Infected Persons

Nancy Crum–Cianflone, Gary Collins, Sheila Medina, Dean Asher, Richard Campin, Mary Bavaro, Braden Hale, Charles Hames

Pathology Analysis Reveals That Dysplastic Pancreatic Ductal Lesions Are Frequent in Patients With Hereditary Pancreatitis

Vinciane Rebours, Philippe Lévy, Jean–François Mosnier, Jean–Yves Scoazec, Marie–Sophie Soubeyrand, Jean–François Fléjou, Bruno Turlin, Pascal Hammel, Philippe Ruszniewski, Pierre Bedossa, Anne Couvelard
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Blitzkrieg for Barrett's Esophagus Containing Early Neoplasia

George Triadafilopoulos

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Clinical Gastroenterology and Hepatology in the News

Research from CGH has received national coverage from major news outlets such as The Washington Post, The New York Times, and Reuters!

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Thank You to Our 2009 Reviewers

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Wanted: Editor-in-Chief for Gastroenterology

Applications due April 1, 2010. Term begins July 1, 2011. Read more.

New! CGH Supplemental Issue on Pancreatic and Biliary Disease

Read the November 2009 supplement to CGH, “Inflammation and Carcinogenesis in the Pancreas and Biliary Tract: Mechanism and Practice”. Based on the proceedings from the fifth annual joint meeting of the AGA and the Japanese Society of Gastroenterology, world-renowned experts present information about the mechanisms, emerging diagnostic modalities, and natural history of pancreatobiliary disease.

AGA Institute Course on Sedation

To learn more about the administration of sedation, attend the AGA Institute’s course, Sedation Competencies for the Endoscopy Team: A Hands-on Course for Gastroenterologists and Nurses on Jan. 17, 2010 in Las Vegas. View details at www.gilearn.org/sedationcourse.

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Education Practice

Severe Gastroparesis: Medical Therapy or Gastric Electrical Stimulation

Savio C. Reddymasu, Irene Sarosiek, Richard W. McCallum

A 33-year-old woman is referred for evaluation of refractory nausea and vomiting of 8 months' duration. She has a 20-year history of type I diabetes mellitus complicated by retinopathy and peripheral neuropathy. Her glycemic control is suboptimal and occasionally blood sugars are in the 20-mmol/L (360 mg/dL) range and the recent hemoglobin A1c level is 9.8%.


Review

Effects of Helicobacter pylori Eradication on Early Stage Gastric Mucosa–Associated Lymphoid Tissue Lymphoma

Angelo Zullo, Cesare Hassan, Francesca Cristofari, Alessandro Andriani, Vincenzo De Francesco, Enzo Ierardi, Silverio Tomao, Manfred Stolte, Sergio Morini, Dino Vaira

Different remission rates of gastric low-grade, B-cell, mucosa–associated lymphoid tissue (MALT) lymphoma have been reported after Helicobacter pylori eradication. We assessed the long-term remission and relapse rates of early stage MALT lymphoma in patients treated only by H pylori eradication and identified factors that might predict outcome.


Editorial

Anesthesia-Mediated Sedation for Advanced Endoscopic Procedures and Cardiopulmonary Complications: Of Mountains and Molehills

John J. Vargo

Anesthesiologist-administered sedation for gastrointestinal endoscopy has become an indelible and somewhat controversial part of our practice landscape. I am not here to expound upon the pharmacoeconomic and regulatory maelstrom that propofol-mediated sedation has created or tout the fact that the safety record for endoscopist-directed propofol is impressive.