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Open Journal of Gastroenterology and Hepatology

Gastroenterology and Hepatology, Hot Articles

DEPIST’C PHARMA : An innovative outreach HCV screening project in pharmacy for general population

Research Article of Open Journal of Gastroenterology and Hepatology DEPIST’C PHARMA : An innovative outreach HCV screening project in pharmacy for general population REMY Andre-Jean1, ALBERT Olivier2, PUGET Eric3, FONTAINE Sebastien1, H BOUCHIRA Hakim, HERVET Jeremy1, ROY Berengere1, HAPPIETTE Arnaud1 1Mobile Hepatitis Team, Perpignan Hospital, France; 2Pharmacy du Port, Port La Nouvelle, France; 3harmacy Poirotte, Perpignan, France Background and Aims:  Hepatitis C testing is still insufficient in France. Beyond defined groups with risk behaviors, hepatitis C testing should now be directed at the general population. The French pharmacies territorial coverage is excellent, and pharmacists are increasingly involved in public health actions (therapeutic education, vaccination against the flu). French Public Health Act on Innovation thank to the “Article 51” allow enables health care teams to propose experiments aimed at improving the diagnostic and/or therapeutic management of a disease. This funding methods and organization is unprecedented. Our aim was to screen for hepatitis C in pharmacies  with POCT performed by pharmacists. Methodology:  Pharmacist recruitment was done on a voluntary basis from different pharmacies on a population pool of 600,000 inhabitants. Pharmacists received training and education appropriate to the POC testing. At request of the health authorities, screening was only proposed for patients with one or more risk factors (national health agency list). There were planned 10 tests per week per pharmacy over 12 months for a total of 5,000 tests. Expected prevalence was 10%. Patients with positive POCT were tested for HCV viral load real-time and for liver fibrosis assessment by FIBROSCAN. They could be treated with HCV antiviral direct agents. Results:  37 pharmacists representing 32 pharmacies were trained to POCT use and announcement of results during 4 half days session. 9 pharmacies were located in agglomeration, including 5 in working-class areas, 7 in rural area, 7 in seaside area and 2 ...
Gastroenterology and Hepatology, Hot Articles

Course of Care for Hepatitis C in Users of Psycho-active Substances According to the Addictological System of Care and Place of the Test and Treat Strategy

Research Article of Open Journal of Gastroenterology and Hepatology Course of Care for Hepatitis C in Users of Psycho-active Substances According to the Addictological System of Care and Place of the Test and Treat Strategy Coraline Biehler 1, Frédéric Chaffraix 2,3, Fiorant Di Nino 1,2, Camille Brand 1, Flavie Oster 1, Samira Fafi-Kremer 4, Gauthier Waeckerle 1, Michel Hasselmann 1, Michel Doffoël 2,3 1 Association Ithaque, 12 rue Kuhn, 67000 STRASBOURG, France; 2 Association de Lutte contre les Maladies du Foie (ALMAF), 23 rue de la 1ère Armée, 67000 STRASBOURG, France; 3 Service Expert de Lutte contre les Hépatites Virales d’Alsace (SELHVA), Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil- Pole Hépato Digestif, 1 place de l’hôpital - BP426, 67091 STRASBOURG Cedex, France; 4 Laboratoire de Virologie, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, 1 place de l’hôpital - BP426, 67091 STRASBOURG Cedex, France Aim: The treatment of addiction is well structured in France, with different care and prevention services available, such as addiction treatment and prevention centers, the network of medical microstructures centred on general practitioners, and lower risk consumption rooms. The objectives of our study were to compare the courses of care for hepatitis C provided within one addictology center offering all three of these services, as well as to clarify the role and factors associated with the test and treat strategy. Methods: 573 users were included prospectively from all three of the above-mentioned services: 168 from the addiction treatment and prevention center, 291 from the network of medical microstructures and 114 from the lower risk consumption room. They were consumers of one or several psycho-active substances (illegal substances, alcohol, tobacco). The different hepatitis C courses of care were compared between the three services. The test and treat strategy was evaluated in comparison with conventional strategy in all the ...
Gastroenterology and Hepatology, Hot Articles

Trends in Herbal and Dietary Supplement Use Among U. S. Adults with Chronic Liver Disease

Review Article of Open Journal of Gastroenterology and Hepatology Trends in Herbal and Dietary Supplement Use Among U. S. Adults with Chronic Liver Disease Khan Aa,b*, Mitsuhashi, Sa, Chauhan Ka, Mujumdar Sa, Erwin Ra, Zheng Ma, Yalamanchili Sa, Reddy Sa, Navarro Vc, Halegoua-DeMarzio Da,b* a Thomas Jefferson University Hospital, Department of Medicine, Philadelphia, PA, USA; b Thomas Jefferson University, Department of Medicine, Division of Gastroenterology & Hepatology, Philadelphia, PA, USA; c Einstein Medical Center, Department of Medicine, Division of Gastroenterology & Hepatology, Philadelphia, PA, USA Herbal and dietary supplements (HDS) are used by over 50% of Americans, but commonly their use is not reported to healthcare providers. The aim of this study is to determine the prevalence of HDS use among patients with Chronic Liver Disease (CLD), with a focus on those using supplements known to cause hepatotoxicity. We accessed 61,951 individuals polled in the NHANES database between 2001-2011, which represented a population size of 1,763,482,931. 573 respondents reported a history of CLD (population size of 19,998,331.655). Of those 573 respondents, 41 respondents (population size 1,399,884) endorsed using HDS that are associated with causing hepatotoxicity, which are listed under the NIH complied master list. Our study demonstrates the need for better counseling of patients on the potential risks of these readily available products. Declaration of conflict of interest: The authors declare no conflict of interest. Keywords: Herbal supplements; dietary supplements; Chronic liver disease; End stage liver disease; hepatotoxicity; Herbalife; Hydroxycut; Drug induced liver injury ...
Gastroenterology and Hepatology, Hot Articles

Hemostatic clips’ retention in the upper GI tract, A report of two cases with prolonged clip retention

Case Report of Open Journal of Gastroenterology and Hepatology Hemostatic clips' retention in the upper GI tract, A report of two cases with prolonged clip retention Tahini Ali1, Alkhatib Amani1, Matar Rami2, Hallal Marwa3, Maitar Michael4, Hallal Mahmoud5* 1Lebanese university, school of medical sciences; 2St George's University ,USA;3Faculty of medicine ,Lebanese American University ,Byblos,Lebanon; 4Southern ILLinois university School of medicine; 5AlZahraa Hospital University Medical Center, affiliated with Lebanese University school of medical sciences ,Beirut Lebanon. The metallic endoscopic clip was first described for hemostasis in 1975. [1] Endoscopic clips are now frequently used in non-variceal upper gastrointestinal bleeding, and have many different indications. [1] Most clips are not magnetic resonance imaging [MRI]-safe, and are contraindications to MRI. [2]  The hemostatic clips usually spontaneously dislodge within 1 to 3 weeks after placement, but some case reports have shown that they can be retained for up to 2 years. [5] Hemostatic clips retention until ulcers healed could promote permanent endoscopic hemostasis of both severe ulcer hemorrhage and very severe hemorrhage related to inpatient ulcer bleeding. [3] Given the short retention time, most physicians rarely advise their patients to abstain from diagnostic procedures that would be contraindicated with a hemostatic clips placed, such as magnetic resonance imaging. [5]  Two cases will be reported for retained clips more than 2 years with a review about risks for clip retaining, MRI compatibility, and retrieving retained clips. Keywords: Hemostatic clips' retention; upper GI tract; prolonged clip retention ...

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