A recent prospective cohort study suggests that a blood test might be a reliable method for diagnosing some adults with suspected celiac disease, potentially eliminating the need for a biopsy. In the study of 436 adults without IgA deficiency, a serum anti-tissue transglutaminase IgA (tTG-IgA) test was compared with the gold standard of duodenal biopsy. The serum test identified 348 true positives and 66 true negatives but also had 15 false positives and seven false negatives. The research, led by Carolina Ciacci, MD, from the University of Salerno in Italy, found the blood test’s positive predictive value to be 95.9%…
Author: Abhay Panchal
Mergers and acquisitions (M&As) have significantly impacted private practice medicine over the past five years. Many physicians are aware of this trend and have either considered or completed a practice sale or merger. The article, authored by David B. Mandell, JD, MBA, and Jason M. O’Dell, MS, CWM, highlights three essential steps for a successful practice M&A: Financially Prepare the Practice: This involves organizing books and records and maximizing the practice’s value to potential acquirers. Implementing processes and procedures for non-clinical aspects can add value to the practice. It’s also crucial to maximize EBITDA (earnings before interest, taxes, depreciation, and…
In June 2023, a multisociety group agreed to change the name of the disease formerly known as nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction–associated steatotic liver disease (MASLD). In the week leading up to this, Intercept Pharmaceuticals announced that their program to develop obeticholic acid (OCA) as a first-to-market, long-awaited potential drug therapy for metabolic dysfunction–associated steatohepatitis (MASH), the more pathogenic form of this disease, was being abandoned after the US Food and Drug Administration (FDA) Gastrointestinal Drugs Advisory Committee voted against accelerated approval of the drug. This decision was made in large part owing to data showing modest…
Gastroenterology, while a widely recognized medical specialty, is often misunderstood. Dr. Benjamin Levy III, a gastroenterologist at the University of Chicago Medicine, addressed some of the most common misconceptions in a discussion with Becker’s: In conclusion, gastroenterology is a multifaceted specialty that goes beyond mere diagnostics, playing a crucial role in the prevention of various cancers and the treatment of a wide range of digestive conditions.
In this edition of “Sharma’s Endoscopy Insights,” I highlight two studies related to resection—an approach to ulcerative colitis–related lesions and a through-the-scope suturing system for closing mucosal defects after endoscopic resection—and a third study on palliation of dysphagia for patients with advanced esophageal cancer. Patients with long-standing UC can develop neoplasia. Several cases of endoscopic treatment have been reported. In this retrospective series, investigators reported success using endoscopic mucosal resection and endoscopic submucosal dissection for a patient population with UC-associated neoplasia but point out the potential for adverse events associated with endoscopic approaches, as well as the development of metachronous…
A recent study has highlighted the concerning low levels of clinician recommendations for colorectal cancer screening during wellness visits. The research, led by Jordan Baeker Bispo, PhD, MPH, from the American Cancer Society, analyzed data from over 5,000 adults who were overdue for such screenings. The findings revealed that less than 30% of these patients received a screening recommendation during their wellness visit. This percentage dropped to below 15% for individuals without a regular source of care or insurance. Despite clinicians reporting that they frequently recommend colorectal cancer screenings, the patient-reported data suggests otherwise, indicating a significant discrepancy. The study…
US Digestive Health (USDH), one of the largest gastroenterology practices in the U.S., has announced a partnership with GI Specialists of Delaware, a specialty practice based in Wilmington. This collaboration aims to expand USDH’s presence in Delaware, offering top-tier gastroenterological care to New Castle County residents. Patients of GI Specialists of Delaware will maintain access to the Limestone Medical Center in Wilmington and the ASC at Glasgow Medical Center in Newark. Jerry Tillinger, CEO of USDHM, praised GI Specialists of Delaware for their commitment to innovative digestive health solutions. Michael Brooks, MD, the lead physician, sees the partnership as an…
Considering disease stage and indications for treatment allows for more personalized recommendations for use of beta-blockers for bleeding prevention in patients with cirrhosis, according to a recent literature review. The therapeutic window for use of nonselective beta-blockers (NSBBs) traditionally was though to open when patients had high-risk varices, regardless of whether they had diuretic-responsive ascites, (Child-Pugh class B/C) and close when decompensated cirrhosis progressed to refractory ascites, the authors noted (J Hepatol 2023;78[4]:866-872).
In June, UnitedHealthcare introduced a new advanced notification system for patients undergoing specific procedures like esophagogastroduodenoscopies, capsule endoscopies, diagnostic colonoscopies, and surveillance colonoscopies. Although gastroenterologists were pleased that the initially proposed prior authorization rules were not implemented, many still expressed reservations and skepticism about the advanced notification and gold carding process. Dr. Benjamin Levy, a gastroenterologist at the University of Chicago Medicine, stated that while the advanced notification system is preferable to prior authorization, there are still concerns about potential delays in diagnosing cancer in patients with alarming symptoms and general medical management. The medical community was relieved when the…
Recent research published in JAMA Internal Medicine has shed light on the effectiveness of cancer screenings. Dr. A. M. McCarthy, University of Oslo, Norway; The study, led by Michael Brethauer, found that most routine cancer screenings prolong patient survival. A notable exception was sigmoidoscopy, for colorectal cancer screening, which showed a potential benefit of 110 days overall. While many doctors support cancer screening as a way to save lives, it is important to weigh the benefits against the potential harms. For example, colon cancer screening can sometimes cause complications such as bleeding or perforation. Studies show that while certain tests…