Author: Abhay Panchal

Private medical practices are a hot commodity right now as private equity firms narrow their focus on merger and acquisition (M&A) opportunities. With medical services continuing to shift from hospital environments to outpatient facilities, health care investors are looking for practices that can expand their current network and capabilities. In fact, 60% of health care investors surveyed by KPMG said they expect M&A activity to increase this year.

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Abstract: Barrett esophagus (BE) is the only known precursor to esophageal adenocarcinoma (EAC), a cancer that continues to have a poor 5-year survival rate of 20%. Current BE screening strategies aim to detect BE and EAC at early, curable stages, but the majority of patients with EAC are diagnosed outside of BE screening and surveillance programs. Guidelines around the world suggest screening for BE in patients with gastroesophageal reflux disease (GERD) and additional demographic and clinical risk factors using high-definition white-light endoscopy (HDWLE). However, current strategies relying on HDWLE are problematic with high direct and indirect costs, procedural risks, and…

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Exercise training is crucial in managing nonalcoholic fatty liver disease (NAFLD), but its ability to significantly improve liver fat remains uncertain. For a study, researchers sought to investigate the association between exercise training and the attainment of validated thresholds for MRI-measured treatment response. Through March 2022, randomized controlled trials involving adults with NAFLD were identified. Exercise training was compared with no exercise training, and the primary outcome was achieving a ≥30% relative reduction in MRI-measured liver fat—a threshold indicative of histologic improvement in nonalcoholic steatohepatitis activity, resolution of nonalcoholic steatohepatitis, and liver fibrosis stage. Different exercise doses were also compared.

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Disorders of gut–brain interaction (DGBI) are highly prevalent chronic gastrointestinal symptoms that are categorised into 33 disorders delineated by gastrointestinal anatomic region. 1 DGBI can occur in isolation, but frequently are present in combinations that affect multiple anatomic regions. The coexistence of multiple DBGI in an individual, termed overlap, has been linked to worse disease severity and quality of life. 2 However, the actual prevalence of DGBI overlap and associated features have remained unknown until Thomas Fairlie and colleagues 3 conducted a systematic review and meta-analysis on the topic. Among 46 studies including 75 682 adults with DGBI, the authors found…

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DescriptionThe purpose of this AGA Institute Clinical Practice Update is to review the available evidence supporting and examine opportunities for future research in endoscopic ultrasound–guided vascular investigation and therapies. MethodsThis Clinical Practice Update was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership, and underwent internal peer review by the Clinical Practice Updates Committee and external peer review through standard procedures of Clinical Gastroenterology and Hepatology. This expert commentary incorporates important as well as recently published studies in…

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Noting that the term “nonalcoholic fatty liver disease” (NAFLD) is stigmatizing, an international group of medical organizations proposed a name change to “metabolic dysfunction-associated steatotic liver disease” (MASLD). This new name, formulated by 236 experts from 54 countries, was recently announced in a consensus statement in the journal Hepatology opens in a new tab or window, after 74% of panelists agreed that the current name was “sufficiently flawed.” “The consensus was the result of a transparent and fair process that engaged the global community and the patient community,” said panelist Meena B. Bansal, MD, of the Icahn School of Medicine…

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Fee-for-service payments encourage high-volume services rather than high-quality care. Alternative payment models (APMs) aim to realign financing to support high-value services. The 2 main components of gastroenterologic care, procedures and chronic care management, call for a range of APMs. The first step for gastroenterologists is to identify the most important conditions and opportunities to improve care and reduce waste that do not require financial support. We describe examples of delivery reforms and emerging APMs to accomplish these care improvements. A bundled payment for an episode of care, in which a provider is given a lump sum payment to cover the…

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The article discusses the guidelines and considerations for determining when and how to stop surveillance colonoscopy in patients with a history of colorectal neoplasia. Surveillance colonoscopy is a commonly used procedure to monitor patients who have previously undergone treatment for colorectal cancer or its precursors. However, the optimal timing and cessation of surveillance colonoscopy remain unclear.

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July 5, 2023 — In the mid-1980s, Louis Aronne strolled into a lab at Rockefeller University where a colleague was breeding mice. “I will never forget what he showed me,” said Aronne, now the director of obesity research and treatment at Weill Cornell Medicine in New York City. “He had a cage with 10 mice, one severely obese and the others normal weight. He took blood from one of the thin mice and gave it to the fat mouse.” When Aronne returned 3 days later, that obese mouse had turned thin. It was proof of something Aronne already suspected: Obesity…

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