What Is The Likelihood That My Patient With Chronic Hepatitis C Will Develop Cirrhosis, Hepatocellular Carcinoma, And/or Hepatic Decompensation?

The natural history of patients following chronic HCV. Numbers in parentheses reflect the percentage of the total group of persons with chronic HCV infection

The cirrhosis risk score may prove to be very useful in identifying patients with significant risk for developing cirrhosis and reduce the need for liver biopsy. Approximately 3% to 5% of HCV patients with stable cirrhosis are at risk to develop hepatic decompensation per year; another 1% to 3% will develop HCC. As a result, monitoring and screening patients with HCV and cirrhosis on a regular basis are imperative. Since patients with any degree of fibrosis are at risk to progress, all such patients should be considered candidates for treatment with peginterferon and ribavirin. References 1. Kim WR. The burden of hepatitis C in the United States. Hepatology. 2002;36(5 Suppl 1):S30-S34. 2. Yano M, Kumada H, Kage M, et al. The long term pathological evolution of chronic hepatitis C. Hepatology. 1996;23:1334-1340. 3. Poynard T, Bedossa P, Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. Lancet.

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Alternative Medicine Use by Canadian Ambulatory Gastroenterology Patients: Secular Trend or Epidemic?

“Takeda Canada’s primary goal will be to help bring important medicines to the patients in Canada who need them.” Currently, Takeda focuses on therapeutic areas that include diabetes, cardiovascular disease, central nervous system disorders, gastroenterology, bone and joint disorders, chronic kidney disease/anemia and gynecological disorders. Takeda Canada will register and commercialize medicines from Takeda’s portfolio of primary care and specialty products. Takeda Canada intends to file its first New Drug Submission (NDS) with the Canadian Health Authority by the end of 2009. “Our government is pleased to welcome Takeda Pharmaceuticals to Ontario – we’re proud that Takeda chose Ontario to be the home of their Canadian headquarters,” said Sandra Pupatello, minister of International Trade and Investment. “This decision speaks to our highly skilled workforce, leadership in innovation, and competitive business climate.” Daaron Dohler will serve as the general manager and president of the new entity as of April 1, 2009. Dohler’s recent responsibilities at Takeda have included leading Takeda’s Global Alliance Research department and creating Takeda’s Global Alliance Management organization. During his career in the pharmaceutical industry, he has worked in a variety of different roles including marketing, business development, new drug development, and operations. Dohler received his MBA from the Kellogg Graduate School of Management and his undergraduate degree from Northwestern University. Takeda Pharmaceutical Company Limited Located in Osaka, Japan, Takeda is a research-based global company with its main focus on pharmaceuticals. As the largest pharmaceutical company in Japan, and one of the global leaders of the industry, Takeda is committed to striving toward better health for individuals and progress in medicine by developing superior pharmaceutical products. Additional information about Takeda is available through its corporate website, http://www.takeda.com . Takeda Pharmaceuticals North America, Inc. and Takeda Global Research & Development Center, Inc.

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Canadian Association of Gastroenterology: Open Letter to Canadians

Meanwhile, Canadians have told Statistics Canada that waiting lists and wait times rank among their top health concerns. Despite the harsh realities surrounding digestive disease, Canadians must wait an inordinate amount of time for gastro-intestinal consultations and access to specialized testing. Case in point: 25% of patients with alarm symptoms, indicators of disease such as cancer, are forced to wait 4 months before their case is seen by a specialist. That’s far longer than the 3 weeks Canadians have told us that they’re willing to wait. Frankly, four months is unacceptable. It is time we got our priorities straight. Surprisingly, in developing its wait list reform of the Canadian health care system, Paul Martin’s government overlooked digestive disease. The Canadian Association of Gastroenterology has sent a call to action to Prime Minister Paul Martin, urging him to include digestive disease as a health-care priority and ensure Canadian patients obtain necessary and timely access to our specialists. Canadian gastroenterologists are already out of the starting block. The Canadian Association of Gastroenterology has done its homework, talked to patients, and is now armed with information that will be crucial in improving the Canadian health care system. We have developed 24 recommended targets for medically-acceptable wait times for gastroenterology, based on a study conducted by nearly 200 Canadian GI specialists who captured data on 5,500 patient visits. We are ready to work with Canadians to make Paul Martin’s government pay attention.

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Takeda Establishes Presence in Canada

METHODS: An 80-item questionnaire, addressing symptoms, general health, quality of life, and AM use, was administered and analyzed using logistic regression. RESULTS: 52.5% of 341 participants used AM in the previous year. Most commonly used were herbal medicine (45.2% of users; 95% CI 35.452.5%), chiropractor (40.7%; 95% CI 31.448.0%), and massage therapy (22.9%; 95% CI 15.929.1%). Reasons prompting AM use were ineffective medical therapy (39.5%; 95% CI 30.446.8%), a greater sense of self-control (29.1%; 95% CI 21.235.7%), agreement with personal beliefs (19.5%; 95% CI 13.125.4%), and conventional drug adverse-effects (17.3%; 95% CI 11.222.9%). AM use was predicted as follows: (1) higher education (odds ratio (OR) 2.10; 95% CI 1.223.60), (2) comorbid medical conditions (OR 1.80; 95% CI 1.083.00), 3) poor mental component summary score of the SF-12 health survey (OR 1.04; 95% CI 1.011.07), and (4) higher annual income (OR 1.17; 95% CI 1.0011.36), but was not related to response to conventional medical therapy. AM practitioners had instructed 8.6% to change prescription medications. AM usage for gastrointestinal disease was greater in patients with IBD (44.6%vs 10.0%; p< 0.05), who were more likely to cite adverse drug effects as a reason for AM use (28.9 vs 14.4%; p= 0.03). CONCLUSIONS: AM was used by 52.5% of gastroenterology outpatients and its use was greater in those with a higher level of education, comorbid conditions, poorer mental health-related quality of life, and higher income. Drug-related side effects also led to increased AM use. Main navigation Crohn's & Colitis Foundation of America $job2.location

go to this site http://www.nature.com/ajg/journal/v99/n2/abs/ajg200464a.html

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