August 2018 Vol XLII Issue 8

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NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #178

Full Force Enteral Nutrition - A New Hope, or the Dark Side? A Critical Look at Enhanced Enteral Feeding Protocols

Joe Krenitsky

In this article, we take a close look at enhanced enteral nutrition (EN) protocols, including volumebased feeding (VBF), which have been highly promoted. Evidence suggests that some enhanced EN protocols may be harmful to some critically ill adult patients and should be avoided. Although observational studies have reported an association between delayed provision of goal nutrition and compromised patient outcomes, interventional studies have reported more compromised outcomes than benefits from early goal nutrition and VBF in critically ill adult patients.



DISPATCHES FROM THE GUILD CONFERENCE, SERIES #15

Management of the Complications of Cirrhosis

Guadalupe Garcia-Tsao

Cirrhosis is the end result of any chronic liver disease and is an entity that progresses across different prognostic stages, the most important being the compensated (asymptomatic) and the decompensated (symptomatic) stages. Here, we discuss these stages, defined by the absence or presence of overt complications of cirrhosis, specifically variceal hemorrhage, ascites and encephalopathy.1 Each stage has entirely different prognosis, predictors of death and predominant pathogenic mechanisms and therefore should be managed separately both in research and in practice.



A SPECIAL ARTICLE

Hepatocellular Carcinoma Secondary to Chronic Hepatitis C Virus Infection in Veterans at the VA Caribbean Healthcare System - Have Surveillance Measures Been Effective?

Sheryl Rosa, Walisbeth Class, Henry DeJesus, Doris H. Toro

The incidence of hepatocellular carcinoma (HCC) due to hepatitis C virus (HCV) infection has been rising worldwide as well as in the United States. Current American Association for the Study of Liver Disease (AASLD) guidelines recommend performing an abdominal ultrasound in cirrhotic patients every six months for early detection of HCC. The main objective of this study was to retrospectively evaluate a population diagnosed with HCC secondary to HCV in the Veterans Administration (VA) Caribbean Healthcare system and to determine if screening strategies were applied appropriately. Secondary aims were to describe certain patient characteristics upon diagnosis of HCC and determine the median survival time of this population. It was found that in 95.4% of the cases, the diagnosis of HCC was incidental, and not part of a surveillance strategy. More so, the median survival after diagnosis was only 10 months. These findings should help raise awareness of the importance of HCC surveillance in cirrhotic patients with or without HCV.



Departments Section


Medical Bulletin Board

FIBER CHOICE® CHEWABLE PREBIOTIC FIBER SUPPLEMENT ACHIEVES #1-RECOMMENDED STATUS FROM GASTROENTEROLOGISTS NATIONWIDE

Boca Raton, FL - IM HealthScience® (IMH), innovators of medical foods and dietary supplements, announced a high-quality and replicated nationwide survey conducted among a representative and projectible sample of U.S. gastroenterologists, which revealed Fiber Choice® as the #1-recommended chewable prebiotic fiber brand



EDUCATIONAL WEBINARS AND ON-DEMAND VIDEOS HIGHLIGHT MALNUTRITION AWARENESS WEEK™ SEPTEMBER 24-28, 2018
ASPEN's Annual Campaign to Raise Awareness of Malnutrition Expands Its Reach

SILVER SPRING, MD, July 25, 2018 - Building on the popularity and success of its annual Malnutrition Awareness Week, the American Society for Parenteral and Enteral Nutrition (ASPEN) has expanded the educational opportunities and resources that will be available during this year's event on September 24-28.



Meetings Calendar

September 24-28, 2018, Malnutrition Awareness Week 2018
October 5-10, 2018 American College of Gastroenterology 2018
December 13-15, 2018 Advances in Inflammatory Bowel Diseases - Multidisciplinary Approaches to IBD Patient-Centered Care