A Quality Improvement Study on Colonoscopy Wait Times in Underinsured Patients Following the COVID-19 Pandemic.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic limited access to colonoscopy. To advance colorectal cancer health equity, we conducted a quality improvement study on colonoscopy wait times in 2019-2023 for underinsured (Medicaid, uninsured) compared with insured patients at an academic medical center providing colonoscopy for surrounding Federally Qualified Health Centers.

Methods: Retrospective chart reviews were performed on adult outpatient colonoscopies in the preintervention period (2019-2021).

Symptomatic Colorectal Cancer Is Associated With Stage IV Diagnosis in Two Disparate Populations.

In the United States, individuals of Black/African Ancestry (AA) have a higher incidence and mortality from colorectal cancer (CRC) compared to individuals of White/European Ancestry (EA). In order to develop an approach towards disentangling the complex effects of associated race and socioeconomic factors on CRC outcome, we have conducted a manual chart review of sporadic CRC pathological diagnoses (total n = 334) at an urban public hospital (UH) and a suburban university hospital (SH). There were significant differences between the SH and UH CRC patients with respect to Black/AA race (4.

Black voices in gastroenterology and hepatology.

The Association of Black Gastroenterologists and Hepatologists (ABGH) was established to improve health equity in Black communities and to provide academic and social support for Black gastroenterologists and hepatologists. In this Viewpoint, four members of ABGH (early career, mid-career and late career) discuss their route into gastroenterology and hepatology, how academia and medicine can promote inclusivity and equity, and their advice to Black students interested in a career in medicine or science.

Achalasia: physiology and diagnosis.

Achalasia is a rare motility disorder with incomplete relaxation of the lower esophageal sphincter and ineffective contractions of the esophageal body. It has been hypothesized that achalasia does not result from only one pathway but rather involves a combination of infectious, autoimmune, and familial etiological components. On the basis of other observations, a novel hypothesis suggests that a muscular form of eosinophilic esophagitis is involved in the pathophysiology of achalasia in some patients.

Diagnosis of gastroesophageal reflux: an update on current and emerging modalities.

Gastroesophageal reflux disease (GERD) is a common condition characterized by troublesome symptoms or esophageal mucosal lesions attributed to excessive esophageal acid exposure. Various pathophysiological mechanisms account for GERD, including impaired esophageal peristalsis and anatomical or physiological defects at the esophagogastric junction (EGJ). Endoscopy identifies GERD complications and detects potential alternative diagnoses.

Pathophysiology and Therapeutic Options for Fecal Incontinence.

Fecal incontinence (FI), defined as the involuntary loss of solid or liquid feces through the anus is a prevalent condition with significant effects on quality of life. FI can affect individuals of all ages and in many cases greatly impairs quality of life but, incontinent patients should not accept their debility as either inevitable or untreatable. The severity of incontinence can range from unintentional elimination of flatus to the complete evacuation of bowel contents.

Advantages of enteral nutrition over parenteral nutrition.

It is a strong and commonly held belief among nutrition clinicians that enteral nutrition is preferable to parenteral nutrition. We provide a narrative review of more recent studies and technical reviews comparing enteral nutrition with parenteral nutrition. Despite significant weaknesses in the existing data, current literature continues to support the use of enteral nutrition in patients requiring nutrition support, over parenteral nutrition.

Safety of enteral feeding in patients with open abdomen, upper gastrointestinal bleed, and perforation peritonitis.

Provision of enteral nutrition (EN) has historically been withheld after major abdominal operations until bowel activity returns. Evidence suggests that EN is safe in critically ill patients with a variety of illnesses, specifically after abdominal surgery. There is a strong association between poor nutrition status and worse outcomes in critically ill patients.

Polypodium leucotomos extract decreases UV-induced Cox-2 expression and inflammation, enhances DNA repair, and decreases mutagenesis in hairless mice.

UV-irradiated skin and UV-induced tumors overexpress the inducible isoform of cyclooxygenase-2 (Cox-2), and Cox-2 inhibition reduces photocarcinogenesis. To evaluate photoprotective effects of Polypodium leucotomos extract (PL), hairless Xpc(+/-) mice were fed for 10 days with PL (300 mg/kg) or vehicle then UV-irradiated, once. By 24 hours, UV-induced Cox-2 levels were increased in vehicle-fed and PL-fed mice, whereas by 48 and 72 hours, Cox-2 levels were four- to fivefold lower in PL-fed mice (P < 0.