Randomized Controlled Trial of Ketamine and Moderate Sedation for Outpatient Endoscopy in Adults.

Introduction: Ketamine is an effective sedative agent in a variety of settings due to its desirable properties including preservation of laryngeal reflexes and lack of cardiovascular depression. We hypothesized that ketamine is an effective alternative to standard moderate sedation (SMS) regimens for patients undergoing endoscopy.

Materials And Methods: We conducted a randomized controlled trial comparing ketamine to SMS for outpatient colonoscopy or esophagogastroduodenoscopy at Brooke Army Medical Center.

Digestive Manifestations in Patients Hospitalized With Coronavirus Disease 2019.

Background & Aims: The prevalence and significance of digestive manifestations in coronavirus disease 2019 (COVID-19) remain uncertain. We aimed to assess the prevalence, spectrum, severity, and significance of digestive manifestations in patients hospitalized with COVID-19.

Methods: Consecutive patients hospitalized with COVID-19 were identified across a geographically diverse alliance of medical centers in North America.

CMV Ileitis: To Treat or Not to Treat? Implications of Initiating Biologic Therapy for Concurrent Crohn's Disease.

Cytomegalovirus (CMV) enteritis is traditionally thought to be a self-limited infection in immunocompetent individuals. Consequently, current guidelines recommend against treating nonimmunocompromised patients with antiviral therapy. Conversely, recent data suggests that spontaneous resolution occurs less frequently than previously believed; furthermore, mortality rate in immunocompetent individuals is similar to that of the immunosuppressed.

Arterial Phase CTA Replacement by a Virtual Arterial Phase Reconstruction from a Venous Phase CTA: Preliminary Results Using Detector-Based Spectral CT.

Objective: To assess the feasibility of creating virtual monoenergetic arterial images from venous phase CTA obtained on a detector-based spectral CT scanner and quantitatively compare the signal-to-noise (SNR) and contrast-to-noise (CNR) ratios of the major arteries to those on polyenergetic true arterial phase images.

Methods: In this retrospective study, 23 patients (15 men and 8 women, median age 68 years) who underwent triple-phase CTA on a spectral CT scanner for aortic endograft surveillance were included. The venous phase CTA of each study was reconstructed to generate virtual monoenergetic images at various keV, which were compared to true arterial phase CTA images.

Nitrous oxide cryotherapy ablation for refractory gastric antral vascular ectasia.

Background: Argon plasma coagulation (APC) is typically the first-line therapy for gastric antral vascular ectasia (GAVE). However, many patients are refractory to APC ablation.

Objective: We examined the safety and efficacy of nitrous oxide CryoBalloon cryotherapy ablation for GAVE refractory to APC.

Gastroduodenal Cryptococcus in an AIDS Patient Presenting With Melena.

Gastrointestinal cryptococcosis is extremely rare with only a few case reports found in the literature and involvement primarily identified post-mortem. This is a case of 54-year-old man with a 20-year history of poorly controlled human immunodeficiency virus presented with constitutional symptoms along with melena. Diagnostic work up with esophagogastroduodenoscopy showed 4 irregular ulcers in the stomach notable for red-pigmented lesions within the ulcers, erythematous mucosa in the antrum and patchy friable mucosa in the duodenum.

Effect of weight loss on nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) has become one of the most common causes of liver disease worldwide and has grown proportionately with the rise in obesity. The prevalence of NAFLD is now thought to be around 20% to 40% of the entire population in industrialized Western countries. Insulin resistance, a product of obesity, is central to the pathogenesis of NAFLD, and is improved with weight loss, making this modality the primary goal of therapy.