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The success of standard treatment for H.pylori has steadily declined. Increased use of antibiotics in foods and medical therapy may have contributed to increasing H. pylori antibiotic resistance.1 While there are some benefits of gastric colonization by H. pylori infection, it is still recognized as a carcinogen by the World Health Organization (WHO) and most […]

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Over the last 25 years of managing the care of patients and families with hereditary colorectal cancer syndromes (HCCS), I have witnessed many changes affecting both patients and practitioners. In particular, the discovery of new HCCS genes affords more patients and families a definitive cause for their disease. New technology for mutational analysis with next […]

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Chronic hepatitis C infection (HCV) is a major public health problem affecting more than 71 million patients worldwide including more than 3.5 million patients in the United States.1 With the introduction of direct acting antiviral agents (DAAs), it is now possible to cure hepatitis C infection even in patients with advanced fibrosis, cirrhosis and HCV […]

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The gut-brain axis is a relatively new focus of research that has rapidly expanded after the development of culture-independent analytic techniques. Of interest to hepatologists is the microbiome-gut-liver- brain axis and its role in the pathogenesis of hepatic encephalopathy (HE). HE is defined as brain dysfunction secondary to liver insufficiency and/or portosystemic shunts, which is […]

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The first esophageal peroral endoscopic myotomy (POEM) series was reported in 2010 by Professor Harohiro Inoue. Seven years later, more than 7,000 procedures have been performed worldwide culminating in a recent AGA Clinical Practice Update stating, “if the expertise is available, POEM should be considered as a treatment option comparable with laparoscopic Heller myotomy for […]

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Epidemiology. Recent data from the U.S. Cancer Statistics registry show that hepatocellular carcinoma (HCC) continues to rise albeit at a slower rate recently (4.5 percent increase annually from 2000 to 2009, and 0.7 percent from 2010 to 2012). Men between 55 and 64 years of age, Hispanics and, at state-level, Texans, are the most commonly […]

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Some of my most painful clinical encounters have been with young persons with advanced colorectal cancer (CRC) in whom opportunities for early diagnosis or prevention were missed: the young woman with obstructing CRC in late pregnancy after 14 months of symptoms that were not evaluated because of lack of insurance and then reluctance to perform […]

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Over 240 million people in the world are chronically infected with hepatitis B virus (HBV). In many infected individuals, initial infection leads to clearance (defined as the loss of surface antigen [HBsAg]). Some HBsAg negative individuals remain HBV DNA positive (i.e., occult HBV) and others have HBV DNA in the liver but are serologically cleared. […]

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Up to 30 percent of patients treated for an initial Clostridium difficile infection (CDI) develop a recurrence within eight weeks of completing a course of anti-CDI therapy and the risk of further recurrence increases with each subsequent episode. Multiply recurrent CDI is a frustrating and debilitating condition that appears to be increasing at a rate […]