Serum β‑hCG as a prognostic marker for colorectal adenocarcinoma in women of reproductive age: A case report and literature review.

Serological and histological examinations have unveiled the presence of free β subunit of human chorionic gonadotropin (β-hCG) in some cases of colorectal adenocarcinoma. The present study describes an unusual case of a young female patient afflicted with rapidly advancing adenocarcinoma of the sigmoid colon. Despite the absence of pregnancy indications on an ultrasound and curettage, a notable elevation of β-hCG was detected in the serum, alongside positive staining in the tumor tissue.

Intensive Care Unit-Related Cholangiopathy-Induced Biliary Cast Syndrome Without Liver Transplantation: A Rare Entity.

The development of biliary cast syndrome (BCS) is very rare, mostly documented in patients with liver transplantation. The etiology of BCS is unknown; however, risk factors include post-liver transplant bile duct injury, ischemia, infection, fasting, parenteral feeding, and increased bile viscosity and gallbladder dysmotility. We present the case of a 41-year-old man who developed BCS secondary to a prolonged intensive care unit course without a liver transplant.

Decoding the diagnostic dilemma: Peripheral T‑cell lymphoma presenting as acute pancreatitis: A case report.

Peripheral T cell lymphoma (PTCL) is a rare form of non-Hodgkin lymphoma characterized by the origin of mature T-cells. PTCL demonstrates atypical clinical features and involves both nodal and extra-nodal sites. The diagnosis and treatment of PTCL can prove to be challenging, as it is often detected at advanced stages and is resistant to conventional chemotherapy treatments.

Addressing Barriers to Care in Hepatocellular Carcinoma: Promoting Equity and Access.

Chronic hepatitis B virus (HBV) infection is the leading cause of hepatocellular carcinoma (HCC). Chronic viral hepatitis is projected to surpass the composite mortality rates of the human immunodeficiency virus (HIV), tuberculosis, and malaria by 2040. It can be attributed to several barriers to chronic HBV infection (CHBVI) surveillance that warrant urgent attention.

Esophageal compression by a common left pulmonary venous trunk.

Dysphagia is a symptom with diverse etiologies including luminal narrowing of the esophagus and motility disorders. Arterial vessels are known to compress the esophagus and cause luminal narrowing. However, identifying a pulmonary venous compression of the esophagus rarely occurs in a patient with dysphagia.

High 30-day readmission rates associated with Clostridiumdifficile infection.

Background: Clostridium difficile infection (CDI) is a leading cause of community-onset and healthcare-associated infection, with high recurrence rates, and associated high morbidity and mortality. We report national rates, leading causes, and predictors of hospital readmission for CDI.

Methods: Retrospective study of data from the 2013 Nationwide Readmissions Database of patients with a primary diagnosis of CDI and re-hospitalization within 30-days.

Small Intestinal Infections.

Small intestinal infections are extremely common worldwide. They may be bacterial, viral, or parasitic in etiology. Most are foodborne or waterborne, with specific etiologies differing by region and with diverse pathophysiologies.

Effect of Recombinant Human Growth Hormone and Rosiglitazone for HIV-Associated Abdominal Fat Accumulation on Adiponectin and other Markers of Inflammation.

Background/objective: In a previous report of HIV-infected patients with fat redistribution, we found that recombinant human growth hormone (rhGH) therapy reduced visceral adipose tissue (VAT) but increased insulin resistance, and that the addition of rosiglitazone reversed the negative effects of rhGH on insulin sensitivity. In this study, we sought to determine the effects of rhGH and rosiglitazone therapy on an array of inflammatory and fibrinolytic markers.

Methods: 72 patients with HIV-associated abdominal obesity and insulin resistance were randomized to treatment with rhGH, rosiglitazone, the combination of rhGH and rosiglitazone, or placebo for 12 weeks.

Alcohol-Attributable Fraction in Liver Disease: Does GDP Per Capita Matter?

Background: The alcohol-attributable fraction (AAF) quantifies alcohol's disease burden. Alcoholic liver disease (ALD) is influenced by alcohol consumption per capita, duration, gender, ethnicity, and other comorbidities. In this study, we investigated the association between AAF/alcohol-related liver mortality and alcohol consumption per capita, while stratifying to per-capita gross domestic product (GDP).

An Atypical Case of Eosinophilic Gastroenteritis Presenting as Hypovolemic Shock.

Eosinophilic gastroenteritis is an uncommon condition characterized by focal or diffuse infiltration of eosinophils in the gastrointestinal tract in the absence of secondary causes. The pathogenesis of this condition is not well understood and its clinical presentation depends on the segment and layer of the gastrointestinal tract affected. The definition of eosinophilic gastroenteritis may be difficult, as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not standardized.

Effect of Gender on the Response to Hepatitis C Treatment in an Inner-City Population.

Introduction: Hepatitis C virus (HCV) is the leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation in the United States. Response to treatment has improved with the addition of direct acting protease inhibitors. However, there are limited real-world data on the role of gender in achieving a sustained virologic response (SVR).

The effect of recombinant human growth hormone with or without rosiglitazone on hepatic fat content in HIV-1-infected individuals: a randomized clinical trial.

Background: Hepatic fat is related to insulin resistance (IR) and visceral adipose tissue (VAT) in HIV+ and uninfected individuals. Growth hormone (GH) reduces VAT but increases IR. We evaluated the effects of recombinant human GH (rhGH) and rosiglitazone (Rosi) on hepatic fat in a substudy of a randomized controlled trial.

Relative effects of heavy alcohol use and hepatitis C in decompensated chronic liver disease in a hospital inpatient population.

Background: Heavy alcohol use has been hypothesized to accelerate disease progression to end-stage liver disease in patients with hepatitis C virus (HCV) infection. In this study, we estimated the relative influences of heavy alcohol use and HCV in decompensated chronic liver disease (CLD).

Methods: Retrospectively, 904 patients with cirrhotic disease admitted to our hospitals during January 2010-December 2012 were identified based on ICD9 codes.

From wasting to obesity, changes in nutritional concerns in HIV/AIDS.

Optimal nutrition is an important part of human immunodeficiency virus (HIV) care; to support the immune system, limit HIV-associated complications as well as maintain better quality of life and survival. The presentation and nature of malnutrition in patients with HIV has changed dramatically over the past 30 years from predominantly a wasting syndrome to lipodystrophy and, now, frailty. Nevertheless, we continue to see all 3 presentations in patient care today.

HIV enteropathy and aging: gastrointestinal immunity, mucosal epithelial barrier, and microbial translocation.

Purpose Of Review: Despite decreases in morbidity and mortality as a result of antiretroviral therapy, gastrointestinal dysfunction remains common in HIV infection. Treated patients are at risk for complications of 'premature' aging, such as cardiovascular disease, osteopenia, neurocognitive decline, malignancies, and frailty. This review summarizes recent observations in this field.

Treatment of chronic hepatitis C virus infection in the United States: some remaining obstacles.

Hepatitis C infection is an important problem in inner city neighbourhoods, which suffer from multiple health disparities. Important factors in this population include alcoholism and substance abuse, mental illness and homelessness, which may be combined with mistrust, poor health literacy, limited access to healthcare and outright discrimination. Systemic barriers to effective care include a lack of capacity to provide comprehensive care, insufficient insurance coverage, poor coordination among caregivers and between caregivers and hospitals, as well as third party payers.

HIV enteropathy: HAART reduces HIV-induced stem cell hyperproliferation and crypt hypertrophy to normal in jejunal mucosa.

Objective: To analyse the structural and kinetic response of small intestinal crypt epithelial cells including stem cells to highly active antiretroviral therapy (HAART).

Design: Crypt size and proliferative activity of transit and stem cells in jejunal mucosa were quantified using morphometric techniques.

Methods: Crypt length was measured by counting the number of enterocytes along one side of a number of crypts in each biopsy specimen and the mean crypt length was calculated.

Recombinant human growth hormone and rosiglitazone for abdominal fat accumulation in HIV-infected patients with insulin resistance: a randomized, double-blind, placebo-controlled, factorial trial.

Background: Recombinant human growth hormone (rhGH) reduces visceral adipose tissue (VAT) volume in HIV-infected patients but can worsen glucose homeostasis and lipoatrophy. We aimed to determine if adding rosiglitazone to rhGH would abrogate the adverse effects of rhGH on insulin sensitivity (SI) and subcutaneous adipose tissue (SAT) volume.

Methodology/principal Findings: Randomized, double-blind, placebo-controlled, multicenter trial using a 2×2 factorial design in which HIV-infected subjects with abdominal obesity and insulin resistance were randomized to rhGH 3 mg daily, rosiglitazone 4 mg twice daily, combination rhGH + rosiglitazone, or double placebo (control) for 12 weeks.

Accelerated gastric emptying but no carbohydrate malabsorption 1 year after gastric bypass surgery (GBP).

Background: Following gastric bypass surgery (GBP), there is a post-prandial rise of incretin and satiety gut peptides. The mechanisms of enhanced incretin release in response to nutrients after GBP is not elucidated and may be in relation to altered nutrient transit time and/or malabsorption.

Methods: Seven morbidly obese subjects (BMI = 44.

Lipodystrophy in HIV patients: its challenges and management approaches.

HIV-associated lipodystrophy is a term used to describe a constellation of body composition (lipoatrophy and lipohypertrophy) and metabolic (dyslipidemia and insulin resistance) alterations that accompany highly active antiretroviral therapy. These changes, which resemble metabolic syndrome, have been associated with a variety of adverse outcomes including accelerated cardiovascular disease. The body composition and metabolic changes appear to cluster in HIV infection, although they are distinct alterations and do not necessarily coexist.

The prevalence and pathogenesis of diabetes mellitus in treated HIV-infection.

HIV-associated morbidity and mortality have declined significantly since the introduction of highly active antiretroviral therapy (HAART). These developments have allowed an increased focus on associated adverse metabolic effects, such as dyslipidemia, diabetes mellitus, and insulin resistance, which are risk factors for cardiovascular disease and other adverse outcomes. The pathophysiologic mechanisms underlying the metabolic changes are complicated and not yet fully elucidated due to the difficulty of separating the effects of HIV infection from those of HAART, co-morbidities, or individual patient vulnerabilities.

Developing an objective evaluation method to estimate diabetes risk in community-based settings.

Background: Exercise interventions often aim to affect abdominal obesity and glucose tolerance, two significant risk factors for type 2 diabetes. Because of limited financial and clinical resources in community and university-based environments, intervention effects are often measured with interviews or questionnaires and correlated with weight loss or body fat indicated by body bioimpedence analysis (BIA). However, self-reported assessments are subject to high levels of bias and low levels of reliability.