In 2012, the U.S. Centers for Disease Control (CDC) recommended one-time screening for hepatitis C virus (HCV) for all adults born from 1945 to 1965 – the “baby boomers.”1 Pennsylvania and New York state legislatures have passed laws making it mandatory for health care providers to offer HCV screening or diagnostic testing for all baby boomer patients.2,3 According to Thomas R. Riley, III, MD, gastroenterology and hepatology, Penn State Health Milton S. Hershey Medical Center, “We just aren’t seeing the numbers of HCV cases that we know are out there in this population; this tells us that it isn’t being detected.” Continue reading
I am excited to join Penn State Health Milton S. Hershey Medical Center Division of Gastroenterology and Hepatology, and be part of a team of highly skilled colleagues who are greatly regarded for excellent clinical care and research.
As I transition to Hershey Medical Center, I’ve had the opportunity to reflect on today’s unique health care climate. It is marked by increased recognition of limited resources and an appropriate shift toward cost efficiency and quality of care outcomes. In this environment, we must be at the forefront of the discussion among stakeholders—patients, clinicians and payers. In line with national and global initiatives to provide more efficient and effective care, we will focus on creating technology-driven and evidence-based clinical care programs across our service region. We plan to develop new collaborative programs with community partners, broadening access to specialty GI care in areas not previously served. The key to the success of this plan is a better understanding of population characteristics influencing disease states and health care choices. Likewise, an integral part of this focus is to define clinical parameters and quality of care measures that accurately and meaningfully describe patient outcomes and the effectiveness of the care we provide in our specialty. Continue reading
Exercise interventions that increase physical activity prior to a patient undergoing surgery or during chemo/radiotherapy for colorectal cancer and other types of cancer have demonstrated improvements in daily activities, social activity, and fatigue, anxiety and depression.1 “If exercise were a drug, it would have no trouble getting FDA approval,” says Niraj J. Gusani, MD, associate professor of surgery, medicine and public health sciences, Penn State Health Milton S. Hershey Medical Center. Dr. Gusani and Amanda B. Cooper, MD, assistant professor of surgery, have launched rigorous research programs for patients with upper GI cancers, studying the effects of physical activity as it relates to recovery from surgery and long-term survival.
To better meet the increasing need for liver transplantation in the U.S. and expand the potential donor pool, living donor liver transplantation (LDLT) is an increasingly viable option.1-3 According to Karen Krok, MD, transplant hepatologist at Penn State Health Milton S. Hershey Medical Center, “Advances in the surgical procedure and donor selection have made the process safer. Overall, donors fare remarkably well afterward. We have had donors who run a marathon within a year after donation!” Dr. Krok directs the LDLT program, where a total of 12 LDLT procedures have been performed since its inception in 2008, with no donor deaths. Continue reading
The Inflammatory Bowel Disease (IBD) Center at Penn State Health Milton S. Hershey Medical Center is one of only a small handful of such centers in the U.S. providing nationally-recognized care to patients suffering from IBD and other related disorders, including Crohn’s disease and ulcerative colitis. Walter A. Koltun, M.D., FACS, FASCRS, chief, division of colon and rectal surgery, and director of the IBD Center, says, “This past spring, since the doors to the new IBD Center opened, physicians specializing in IBD treatment work collaboratively to bring the full spectrum of IBD care under one roof. This dramatically streamlines care for patients with IBD, so that all or most of their needs are coordinated and provided in a single setting.” Continue reading
Findings from a randomized, placebo-controlled, double-blind clinical trial raise doubts about the usefulness of indomethacin for prophylaxis of pancreatitis in all patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).1 Consecutive ERCP patients randomized to receive a single dose of indomethacin (100 mg, rectal) prior to ERCP failed to exhibit any statistically significant decrease in the occurrence of post- ERCP pancreatitis (PEP) (7.9 percent), compared to patients randomized to placebo (4.4 percent). The indomethacin and placebo groups were also similarly likely to experience hospital readmission within 30 days following ERCP (Figure). Continue reading
Multi-gene panels can have a significant impact on the successful identification of patients with or at-risk for hereditary gastrointestinal cancers, such as those associated with Lynch syndrome. According to Maria J. Baker, Ph.D., professor of medicine and genetic counselor, medical geneticist, hematology and oncology, “Multi-gene panels can screen for up to 72 different genes or more, depending on the laboratory, using a single blood sample and eliminating the need for a time-consuming sequence of tests. This can reduce overall costs and shorten the ‘diagnostic odyssey,’ potentially reducing stress for the patient than with traditional sequential genetic testing.” Continue reading