Adenoma Detection Rate: Not Perfect But Still Good!
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 12, 2019 Category: Gastroenterology Authors: Antonio Facciorusso, Siddharth Singh Source Type: research

PROs of Patient-reported Outcomes  for Nonalcoholic Fatty Liver Disease and Effects on Treatment for Nonalcoholic Steatohepatitis
A key part of delivering high-quality patient-centered care is knowing whether our medical interventions help patients feel and function better. Clinical and histologic assessments are the traditional measures used for gauging clinical efficacy and effectiveness in liver disease. Although these are useful for monitoring disease progression, they do not necessarily correlate with how our patients feel, especially among those who have largely asymptomatic disease. Discordance between physicians ’ clinical impression and patients’ perception of their own health is not uncommon. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Maya Balakrishnan, Rohit Loomba Tags: Editorial Source Type: research

Development and Validation of the Mucosal Inflammation Noninvasive Index For Pediatric Crohn ’s Disease
Mucosal healing (MH) has become a goal of therapy for Crohn ’s disease (CD), but frequent endoscopies are not feasible. We aimed to develop and validate a non-invasive index to assess mucosal inflammation in children with CD. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Martinus A. Cozijnsen, Assaf Ben Shoham, Ben Kang, Byung-Ho Choe, Yon Ho Choe, Maria M.E. Jongsma, Richard K. Russell, Frank M. Ruemmele, Johanna C. Escher, Lissy de Ridder, Sibylle Koletzko, Javier Mart ín-de-Carpi, Jeffrey Hyams, Thomas Walters, Anne G Source Type: research

A Massive Roadblock: An Unusual Case of Gastric Outlet Obstruction
A 76-year-old man presented with 1 week of abdominal pain, nausea, and bilious emesis. Liver chemistry values were normal but his lipase level was increased to 394 U/L (reference range, 16 –63 U/L). Computed tomography showed pneumobilia, common bile duct measuring 7 mm, decompressed gallbladder with a fistulous tract to the second portion of the duodenum, and a low-density laminated mass lesion in the third part of the duodenum with marked gastric and esophageal distention (Figure A). Subsequent esophagogastroduodenoscopy showed a massive 8-cm impacted gallstone in the third portion of the duodenum with surrounding ...
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Ruchit N. Shah, Luiz Foernges, Harshit S. Khara Tags: Electronic Image of the Month Source Type: research

What Is the Hang-Up With Optical Diagnosis of Diminutive Colorectal Polyps?
More than a decade ago, Yoshida et  al1 applied the push-button technology of electronic chromoendoscopy to colorectal polyps and differentiated adenomas from non-neoplasms (Figure 1). Since then, intense study has found that both experts and nonexperts can perform this so-called “optical diagnosis” with high, but not perfect, fidelity to pathology with tools already at the fingertips of endoscopists.2 However, universal histology for polyps remains the standard in the United States, and optical diagnosis has not replaced it. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Sarah K. McGill, Swati G. Patel Tags: Editorial Source Type: research

Reply
We appreciate the readers ’ comments on the management of gallbladder stones and cholecystitis in patients with cirrhosis. We agree that surgical options, especially for those with acute cholecystitis in the setting of decompensated cirrhosis, are limited and risky, as we state in the clinical practice update. We also agre e that more study is needed in this population because the literature is limited to retrospective case series. For instance, the meta-analysis cited in the letter1 does not specify the number of patients with cirrhosis included in the study. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Patrick Northup Tags: Letter to the Editor Source Type: research

Authors' Response To Letter to the Editor
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Patrick Northup Source Type: research

Measurement of Forearm Bone Density by Dual Energy X-ray Absorptiometry Increases the Prevalence of Osteoporosis in Men with Celiac Disease
Guidelines advise measurement of bone mineral density (BMD) in patients with a diagnosis of celiac disease. The lumbar spine (LS) and hip sites are usually measured. Although skeletal sites rich in trabecular bone are believed to be vulnerable to osteoporosis in patients with celiac disease, most studies have not measured the cortical distal 1/3-radius. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Marcella D. Walker, John Williams, Suzanne K. Lewis, Julio C. Bai, Benjamin Lebwohl, Peter HR. Green Source Type: research

Development and Validation of the Mucosal Inflammation Non-invasive Index For Pediatric Crohn ’s Disease
Mucosal healing (MH) has become a goal of therapy for Crohn ’s disease (CD), but frequent endoscopies are not feasible. We aimed to develop and validate a non-invasive index to assess mucosal inflammation in children with CD. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Martinus A. Cozijnsen, Assaf Ben Shoham, Ben Kang, Byung-Ho Choe, Yon Ho Choe, Maria ME. Jongsma, Richard K. Russell, Frank M. Ruemmele, Johanna C. Escher, Lissy de Ridder, Sibylle Koletzko, Javier Mart ín-de-Carpi, Jeffrey Hyams, Thomas Walters, Anne Gr Source Type: research

Clock Gene Disruption is an Initial Manifestation of Inflammatory Bowel Disease
Sleep disruption modifies the immune system and can trigger flares of inflammatory bowel diseases (IBD). Changes in expression of clock genes have been reported in patients with IBD. We investigated whether a change in the circadian clock is an early event in development of IBD. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Y. Weintraub, S. Cohen, N. Chapnik, A. Ben-Tov, A. Yerushalmy-Feler, I. Dotan, R. Tauman, O. Froy Source Type: research

A Massive Road Block: An Unusual Case of Gastric Outlet Obstruction
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Ruchit N. Shah, Luiz Foernges, Harshit S. Khara Tags: Image of the Month Source Type: research

A Rare Presentation of Colonic Hemangiomas and Varices
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Milan Patel, Mohammad Bilal Siddiqui, George Smallfield Source Type: research

What is the Hang Up With Optical Diagnosis of Diminutive Colorectal Polyps?
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Sarah McGill, Swati G. Patel Source Type: research

PROs of Patient-reported Outcomes for Nonalcoholic Fatty Liver Disease and Effects on Treatment for Nonalcoholic Steatohepatitis
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Maya Balakrishnan, Rohit Loomba Source Type: research

Colonic Angiosarcoma: a rare gastrointestinal malignancy
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Justin Louie, Sooraj Tejaswi, Karen Matsukuma Tags: Image of the Month Source Type: research

Durability of Interferon-induced Hepatitis B Surface Antigen Seroclearance
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 10, 2019 Category: Gastroenterology Authors: Yali Wu, Yali Liu, Junfeng Lu, Zhenhuan Cao, Yi Jin, Lina Ma, Nan Geng, Shan Ren, Yanhong Zheng, Chengli Shen, Xinyue Chen Source Type: research

Nonceliac Gluten and Wheat Sensitivity
Non-celiac gluten and/or wheat sensitivity (NCGS) is thought to be an immune-mediated reaction to gluten or other components of wheat (eg, fructans or amylase trypsin inhibitors) with intestinal and extraintestinal symptoms which improve once gluten and/or wheat is eliminated from the diet and after a diagnosis of celiac disease and wheat allergy have been excluded with appropriate testing. However, there is a great deal of skepticism within the scientific community questioning the existence of NCGS as a distinct clinical disorder. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 9, 2019 Category: Gastroenterology Authors: Anam Khan, Milena Gould Suarez, Joseph A. Murray Source Type: research

Murky Waters for Diagnosis of Gastroparesis
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 9, 2019 Category: Gastroenterology Authors: David C. Kunkel, John O. Clarke Source Type: research

Non-Celiac Wheat/Gluten Sensitivity
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 9, 2019 Category: Gastroenterology Authors: Anam Khan, Milena Gould Suarez, Joseph A. Murray Source Type: research

Combination of Bismuth and Standard Triple Therapy Eradicates Helicobacter pylori Infection in More than 90% of Patients
Due to the poor eradication rates of standard triple therapy, the addition of bismuth salts has been proposed for first-line eradication of Helicobacter pylori. We assessed the effectiveness and safety of the combination of bismuth and the standard, clarithromycin-containing triple therapy in eradication of H pylori infection, using data from a large multi-center registry. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 9, 2019 Category: Gastroenterology Authors: Adrian G. McNicholl, Dmitry S. Bordin, Alfredo Lucendo, Galina Fadeenko, Manuel Castro Fernandez, Irina Voynovan, Natalia Valerievna Zakharova, Aiman Silkanovna Sarsenbaeva, Luis Bujanda, Ángeles Perez-Aisa, Liudmila Vologzhanina, Oleg Zaytsev, Tatiana I Source Type: research

Colon metastasis of breast cancer with a unique endoscopic finding
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 9, 2019 Category: Gastroenterology Authors: Hironobu Takedomi, Takashi Akutagawa, Yasuhisa Sakata Tags: Image of the Month Source Type: research

Reply
We thank Professor Vasen and colleagues for their thoughtful commentary on our article. Indeed, we share their concerns that invasive screening tests are largely inappropriate for low-risk populations because of the relatively low yield and positive predictive values. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 5, 2019 Category: Gastroenterology Authors: Juan E. Corral, Karl F. Mareth, Douglas L. Riegert-Johnson, Ananya Das, Michael B. Wallace Tags: Letter to the Editor Source Type: research

Exam 1: Gastroesophageal and Laryngopharyngeal Reflux Associated With Laryngeal Malignancy: A Systematic Review and Meta-analysis
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 5, 2019 Category: Gastroenterology Tags: Continuing Medical Education (CME) Activity Source Type: research

Exam 2: Time to Colonoscopy and Risk of Colorectal Cancer in Patients With Positive Results From Fecal Immunochemical Tests
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 5, 2019 Category: Gastroenterology Tags: Continuing Medical Education (CME) Activity Source Type: research

Exam 3: Efficacy of Live Attenuated Herpes Zoster Vaccine in Patients With Inflammatory Bowel Diseases
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 5, 2019 Category: Gastroenterology Tags: Continuing Medical Education (CME) Activity Source Type: research

Response to Vasen et al, Letter to the Editor
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 5, 2019 Category: Gastroenterology Authors: Juan E. Corral, Karl F. Mareth, Douglas L. Riegert-Johnson, Ananya Das, Michael B. Wallace Source Type: research

Glyphosate Excretion is Associated With Steatohepatitis and Advanced Liver Fibrosis in Patients With Fatty Liver Disease
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 4, 2019 Category: Gastroenterology Authors: Paul J. Mills, Cyrielle Caussy, Rohit Loomba Source Type: research

Chronic Diarrhea and Constipation are More Common in Depressed Individuals
Depression is a major health issue in the United States and is highly comorbid with gastrointestinal conditions. We collected data from the National Health and Nutrition Examination Survey (NHANES), a representative sample of the US population, to study the relationship between depression and bowel habits. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 4, 2019 Category: Gastroenterology Authors: Sarah Ballou, Jesse Katon, Prashant Singh, Vikram Rangan, Ha Neul Lee, Courtney McMahon, Johanna Iturrino, Anthony Lembo, Judy Nee Source Type: research

Changes in Time of Gastric Emptying after Surgical and Endoscopic Bariatrics and Weight Loss: A Systematic Review And Meta-Analysis
Gastric emptying (GE) is involved in regulation of appetite. We compared times of GE after different bariatric endoscopic and surgical interventions and associations with weight loss. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 4, 2019 Category: Gastroenterology Authors: Eric J. Vargas, Fateh Bazerbachi, Gerardo Calderon, Larry J. Prokop, Victoria Gomez, M. Hassan Murad, Andres Acosta, Michael Camilleri, Barham K. Abu Dayyeh Source Type: research

Safety, Diagnostic Accuracy, and Effects of Endoscopic Ultrasound Fine-needle Aspiration on Detection of Extra-vascular Migratory Metastases
Tumor cells can migrate via diminutive perivascular cuffing to distant sites along blood vessels to formextra-vascular migratory metastases (EVMM). These metastases are usually identified during surgery or autopsies. We aimed to evaluate the feasibility and safety of endoscopic ultrasound fine-needle aspiration (EUS-FNA) of perivascular soft-tissue cuffs to detect EVMM. We compared findings from EUS with those from non-invasive cross-sectional imaging (reference standard) of patients who underwent EUS-FNA to assess suspected EVMM and studied the effects on pancreatic tumor staging and determination of resectability. (Sourc...
Source: Clinical Gastroenterology and Hepatology - April 3, 2019 Category: Gastroenterology Authors: Tarun Rustagi, Ferga C. Gleeson, Suresh T. Chari, Heidi D. Lehrke, Naoki Takahashi, Thomas M. Malikowski, Barham K. Abu Dayyeh, Vinay Chandrasekhara, Prasad G. Iyer, Michael L. Kendrick, Randall K. Pearson, Bret T. Petersen, Elizabeth Rajan, Rory L. Smoot Source Type: research

Validation study of elastographies in patients with nonalcoholic fatty liver disease for detecting liver fibrosis
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - April 3, 2019 Category: Gastroenterology Authors: Tomoyuki Kawada Source Type: research

Smaller-Diameter Covered Transjugular Intrahepatic Portosystemic Shunt Stents Are Associated With Increased Survival
We studied the effects of diameter of covered, self-expandable, nitinol stents on survival times of patients with a transjugular intrahepatic portosystemic shunt (TIPS). (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 30, 2019 Category: Gastroenterology Authors: Jonel Trebicka, Diana Bastgen, Jonathan Byrtus, Michael Praktiknjo, Sophia Terstiegen, Carsten Meyer, Daniel Thomas, Rolf Fimmers, Markus Treitl, Wulf Euringer, Tilman Sauerbruch, Martin R össle Source Type: research

Gastric bleeding induced by a solitary juvenile polyp
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 30, 2019 Category: Gastroenterology Authors: Yutaka Okagawa, Tetsuya Sumiyoshi, Hitoshi Kondo Tags: Image of the Month Source Type: research

Smaller Diameter Covered Transjugular Intrahepatic Portosystemic Shunt Stents are Associated With Increased Survival
We studied effects of diameter of covered, self-expandable nitinol stents on survival times of patients with a transjugular intrahepatic portosystemic shunt (TIPS). (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 30, 2019 Category: Gastroenterology Authors: Jonel Trebicka, Diana Bastgen, Jonathan Byrtus, Michael Praktiknjo, Sophia Terstiegen, Carsten Meyer, Daniel Thomas, Rolf Fimmers, Markus Treitl, Wulf Euringer, Tilman Sauerbruch, Martin R össle Source Type: research

Incidence of Immune-mediated Inflammatory Diseases Among Patients With Inflammatory Bowel Diseases in Denmark
It is not clear whether the co-occurrence of immune-mediated inflammatory diseases (IMIDs) affects the course of inflammatory bowel diseases (IBD). We investigated the occurrence of IMIDs in relation to onset of IBD and the effects of concurrent IMIDs on IBD outcomes in a nationwide study of the Danish population. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 29, 2019 Category: Gastroenterology Authors: Johan Burisch, Tine Jess, Alexander Egeberg Source Type: research

Clinical and Molecular Features of Post-Colonoscopy Colorectal Cancers
Post-colonoscopy colorectal cancers (PCCRCs) may arise from missed lesions or due to molecular features of tumors that allow them to grow rapidly. We aimed to compare clinical, pathology, and molecular features of PCCRCs (those detected within 6 –60 months of colonoscopy) and detected CRCs (those detected within 6 months of a colonoscopy). (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 28, 2019 Category: Gastroenterology Authors: N. Jewel Samadder, Deb Neklason, Angela Snow, Wade Samowitz, Melissa H. Cessna, Kerry Rowe, Iqbal Sandhu, Kenneth Boucher, Lisa Pappas, Ken Robert Smith, Jathine Wong, Karen Curtin, Dawn Provenzale, Randall W. Burt Source Type: research

Huge Abdominal Abscess Secondary to an Appendiceal Mucinous Neoplasm
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 27, 2019 Category: Gastroenterology Authors: Xing Huang, Zhigang Xiao, Zhongcheng Huang Tags: Image of the Month Source Type: research

Melanosis Coli
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 27, 2019 Category: Gastroenterology Authors: Greg S. Cohen Tags: Image of the Month Source Type: research

Aortogastric fistula: A rare glimpse of catastrophe
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 27, 2019 Category: Gastroenterology Authors: John Ong, Carla Swift, Yasseen Al-Naeeb Tags: Image of the Month Source Type: research

Effect of Accelerated Infliximab Induction on Outcomes of Acute Severe Ulcerative Colitis
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 27, 2019 Category: Gastroenterology Authors: Cong Dai, Min Jiang, Yu-Hong Huang Source Type: research

Improving adenoma detection rates … without a benchmark!
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 27, 2019 Category: Gastroenterology Authors: Alain Braillon Source Type: research

Which is the best option to relieve symptoms of cholecystitis in high-risk cirrhotic patients?
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 27, 2019 Category: Gastroenterology Authors: Giulia Bonato, Edoardo Forti, Massimiliano Mutignani Source Type: research

Appropriate Therapeutic Drug Monitoring of Biologic Agents for Patients With Inflammatory Bowel Diseases
Therapeutic drug monitoring (TDM) is widely available for biologic therapies in patients with inflammatory bowel disease (IBD). We reviewed current data and provided expert opinion regarding the clinical utility of TDM for biologic therapies in IBD. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 27, 2019 Category: Gastroenterology Authors: Konstantinos Papamichael, Adam S. Cheifetz, Gil Y. Melmed, Peter M. Irving, Niels Vande Casteele, Patricia L. Kozuch, Laura E. Raffals, Leonard Baidoo, Brian Bressler, Shane M. Devlin, Jennifer Jones, Gilaad G. Kaplan, Miles P. Sparrow, Fernando S. Velayo Source Type: research

No Increased Risk of Colorectal Adenomas in Spouses of Patients with Colorectal Neoplasia
(Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 27, 2019 Category: Gastroenterology Authors: Anna Krigel, Nicholas P. Tatonetti, Alfred I. Neugut, Benjamin Lebwohl Source Type: research

Quantification of Hepatitis B Core Antibody Helps Predict Clinical Relapse After Cessation of Nucleos(t)ide Analogues in Chronic Hepatitis B Patients: More Needs to Be Done
In this study, the investigators claimed an inverse association between serum level of quantitative hepatitis B virus core antibody (anti-HBc) and the risk of clinical relapse in chronic hepatitis B (CHB) patients who discontinued long-term nucleos(t)ide analogue (NA) therapy. Their findings confirmed our earlier observation that a low serum anti-HBc level ( (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 22, 2019 Category: Gastroenterology Authors: Yao-Chun Hsu, Cheng-Hao Tseng, Jia-Horng Kao Tags: Letter to the Editor Source Type: research

Rome IV Exploratory Model Closely Resemble Asian Functional Gastrointestinal Disorder Symptom Clusters
Clevers et  al1 reported important population-based symptom grouping based on the latest Rome IV questionnaire completed by 5931 participants from the United Kingdom, the United States, and Canada. They found 8 distinct symptom groupings (constipation, diarrhea, irritable bowel syndrome [IBS], abdominal pain, heartburn, nausea/vomiting, globus, and other upper gastrointestinal [GI] symptoms) and reported that these results were consistent with the Rome IV classification for separate upper and lower GI symptoms groups. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 22, 2019 Category: Gastroenterology Authors: Kewin Tien Ho Siah, Kok-Ann Gwee Tags: Letter to the Editor Source Type: research

Acute Hepatitis E is an Underreported Cause of Severe Acute Liver Injury
Breu et  al1 identified hypoxic hepatitis, drug-induced liver injury, hepatobiliary obstruction, and viral hepatitis as the common causes of severe acute liver injury (ALI). In their study and in other recent studies from the United States and Europe, severe ALI has been attributed to acute viral hepatitis in 10% to 15% cases, but acute hepatitis E virus (HEV) infection has been reported in only 4 of 726 (0.6%) episodes.1–3 This is surprising given the high HEV seroprevalence in Central Europe and the United States,4,5 an increasing number of hospitalizations for confirmed HEV infections,6 and med ian peak ...
Source: Clinical Gastroenterology and Hepatology - March 22, 2019 Category: Gastroenterology Authors: Stefanie Quickert, Philipp A. Reuken, Michael Rose, Katharina Boden, Tony Bruns Tags: Letter to the Editor Source Type: research

Reply
We read with interest the comments by Kao et  al that underline the potential of quantitative antibodies against hepatitis B core protein (anti-HBc) in the management of chronic hepatitis B virus (HBV) infection. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 22, 2019 Category: Gastroenterology Authors: Heng Chi, Jie Peng, Harry L.A. Janssen Tags: Letter to the Editor Source Type: research

Reply
The letter by Quickert et  al highlights an additional cause of severe acute liver injury (ALI) not identified in our study: acute hepatitis E virus (HEV). In our cohort, routine testing for HEV was not performed. We therefore recognize that some cases would be reclassified had they undergone all forms of testing. As 1 exam ple, Davern et al1 showed that 7 of 318 (2.2%) patients with clinically diagnosed drug-induced liver injury, which accounted for roughly 1 in 10 cases of ALI in our study, could be reclassified as having HEV. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 22, 2019 Category: Gastroenterology Authors: Anthony C. Breu, Elliot B. Tapper Tags: Letter to the Editor Source Type: research

Do We Need a Randomized Controlled Trial on This Issue? Complete Resolution of Nonalcoholic Fatty Liver Disease After Bariatric Surgery
We read the article by Lee et  al1 with interest. We would like to congratulate the authors for their contribution. They provide a strong scientific basis for the role of bariatric surgery in patients with nonalcoholic fatty liver disease (NAFLD). Although most of the data included in the meta-analysis came from prospective obs ervational studies, it is clear that bariatric surgery reverses NAFLD. However, this effect is not consistent, as some patients progress after surgery, and a few develop de novo NAFLD. (Source: Clinical Gastroenterology and Hepatology)
Source: Clinical Gastroenterology and Hepatology - March 22, 2019 Category: Gastroenterology Authors: Jes ús Morales–Maza, Oscar Santes Tags: Letter to the Editor Source Type: research