Mileshedegaard2133

This technique may help to establish underlying mechanisms and evaluate novel therapeutic approaches to functional dyspepsia.

Although screening reduces colorectal cancer (CRC) incidence and related mortality, national CRC screening rates remain suboptimal. see more Identifying strategies to improve screening rates remains an area of intense focus, and previous literature supports an association between the perceived risk of CRC and a likelihood or intent to complete screening. However, risk estimation alone through the validated National Cancer Institute Colorectal Cancer Risk Assessment Tool does not improve screening uptake compared with general education. Future studies should couple risk estimation with patient navigation and decision support aids to build upon our existing armamentarium of effective interventions.

Although screening reduces colorectal cancer (CRC) incidence and related mortality, national CRC screening rates remain suboptimal. Identifying strategies to improve screening rates remains an area of intense focus, and previous literature supports an association between the perceived risk of CRC and a likelihood or intent to complete screening. However, risk estimation alone through the validated National Cancer Institute Colorectal Cancer Risk Assessment Tool does not improve screening uptake compared with general education. Future studies should couple risk estimation with patient navigation and decision support aids to build upon our existing armamentarium of effective interventions.Nearly 25 years after its initial description, endoscopic therapy of walled-off pancreatic necrosis has become widely accepted. Endoscopic therapy is composed of transmural placement of stents, now most commonly lumen-apposing metal stents and removal of solid debris, if needed. Removal of solid debris can be achieved with irrigation provided by percutaneously or endoscopically placed (nasocystic) tubes or by mechanically through direct necrosectomy. This editorial provides commentary on the use of hydrogen peroxide instilled at the time of direct necrosectomy for treatment of walled-off pancreatic necrosis.

Normal bowel function requires intact sensory pathways. Diminished rectal sensation (rectal hyposensitivity [RH]) is associated with constipation, although its clinical importance remains unclear.

Consecutive patients (aged 18-80) attending a tertiary center (2004-2016) for investigation of refractory functional constipation (Rome IV core criteria defined, applied post hoc) were included. Patients completed a clinical symptom questionnaire and underwent anorectal physiologic investigations, including rectal sensory testing (balloon distension) to determine 3 well-established sensory thresholds. Multivariate regression analyses were performed to evaluate associations between RH, symptomology, and allied physiologic investigations.

Of 2,876 patients meeting inclusion criteria, 722 (25%) had RH based on ≥1 elevated sensory thresholds (0 n = 2,154 [74.9%]; 1 n = 327 [11.4%]; 2 n = 209 [7.3%]; and 3 n = 186 [6.5%]). A linear relationship existed between increasing number of elevated sensory thresholds and coion. Increased number of elevated sensory thresholds is associated with more severe constipation phenotype. These data, in the largest study to date, provide for the first time evidence to show that RH is a major pathophysiologic mechanism in constipation, with recognized clinical impact (http//links.lww.com/AJG/B765).Medical schools implemented holistic review more than a decade ago, which led to more deliberate consideration and inclusion of applicants historically underrepresented in medicine. This article presents a theory of holistic enrollment management that unites holistic review with enrollment management principles. This theory contextualizes medical school admissions as a complex marketplace with multifaceted, competing forces. Applying an enrollment management framework of mission, market, means, and metrics can improve the capacity of a medical school to efficiently advance its mission over time. Medical schools employing a clear, compelling, and focused mission to direct all aspects of the medical education enterprise can more effectively attract applicants who are better prepared to enact that mission throughout their careers. Medical schools share a marketplace and collectively compete to identify, attract, admit, and matriculate the most mission-aligned student body within the pool of applicants they share. Institutions that deliberately mobilize resources within this dynamic marketplace will engage, admit, and matriculate the most suiting applicants and attract even more mission-aligned matriculants over time. Widespread adoption of this holistic framework of enrollment management may enhance the capacity of the medical education system to better capitalize on the existing diversity in the national pool of applicants, encourage more underrepresented applicants to apply in the future, admit and matriculate a more diverse national student body, and ultimately better prepare new physicians to meet the increasingly diverse health care needs of the nation.

Stakeholders have expressed concerns regarding the impact of visiting trainees and physicians from high-income countries (HICs) providing education and/or short-term clinical care in low- and middle-income countries (LMICs). This systematic review aimed to summarize LMIC host perceptions of visiting trainees and physicians from HICs during short-term experiences in global health (STEGH).

In September 2018 then again in August 2020, the authors searched 7 databases (PubMed, Embase, Scopus, Web of Science, ERIC, Cochrane Library, Global Index Medicus) for peer-reviewed studies that described LMIC host perceptions of STEGH. They extracted information pertaining to study design, participant demographics, participant perceptions, representation of LMICs and HICs, and HIC visitors' roles and used thematic synthesis to code the text, develop descriptive themes, and generate analytical themes.

Of the 4,020 studies identified, 17 met the inclusion criteria. In total, the studies included 448 participants, of which 395 (88%) represented LMICs.