Helicobacter Pylori and Gastric Cancer: An Update in the Literature.

Of the chronic bacterial infections that affect humans, Helicobacter pylori (H. pylori) infection is one of the most common. It inhabits the stomachs of half of the adult human population.

Increased Prevalence of Advanced Histologic Features in Small and Diminutive Polyps in Patients Undergoing Surveillance and Diagnostic Colonoscopy.

Objective: Studies addressing small and diminutive polyps and their potential of harboring advanced histologic features (AH) are scarce in Hispanics. We aimed to determine the prevalence of AH in a cohort of Hispanics.

Methods: A retrospective review of medical records of patients who had a colonoscopy from 2005 through 2010.

Molecular and Sociodemographic Colorectal Cancer Disparities in Latinos Living in Puerto Rico.

Background: The incidence of sporadic colorectal cancer (CRC) among individuals <50 years (early-onset CRC) has been increasing in the United States (U.S.) and Puerto Rico.

Acute Liver Infarct with a Superimposed Liver Abscess as a Consequence of Hypercoagulable State in a Patient with COVID-19 without Respiratory Manifestations.

COVID-19 infection has been associated, particularly in severely ill patients requiring hospitalization, with a hypercoagulable state. The case presented herein was a 66-year-old man with SARS-CoV-2 infection who did not have any respiratory symptoms. He presented with the following clinical manifestations: portal vein and hepatic artery thrombosis, liver infarction, and a superimposed abscess of the liver.

The Impact of a Sustained Virologic Response to Hepatitis C Virus Treatment on Liver Stiffness in the Puerto Rico Veterans Attending Liver Clinics in the Veterans Affairs Caribbean Healthcare System.

Objective: To evaluate the impact of sustained virologic response (SVR) on liver stiffness, as measured by transient elastography (TE), in Hispanic patients treated with direct-acting antivirals (DAAs) in the outpatient clinics in the Veterans Affairs Caribbean Healthcare System.

Methods: We included hepatitis C virus (HCV) patients treated with DAA regimens from 11/2017 through 06/2019. Patient demographics and variables such as body mass index, HCV genotype, and treatment regimen were collected.

Effectiveness of Multiple Consecutive Fecal Immunohistochemical Testing for Colorectal Cancer Screening.

Objective: The fecal immunohistochemical test (FIT) is a simple colorectal-cancer screening test. There are no recent studies evaluating the benefits of doing more than one a year. Our study aimed to evaluate the effectiveness of performing the test for 3 consecutive days in terms of detecting cancer and advanced adenomas.

Strongyloides Stercoralis Infection in Hispanic Veterans Living in Puerto Rico: A Tropical Issue or a Global One?

Objective: Strongyloidiasis is a parasitic infection classified by the World Health Organization as a neglected tropical disease. Although predominantly asymptomatic, it can become a life-threatening disease in an immunocompromised host. Epidemiologic studies in the Western Hemisphere are scarce, but even more scarce are descriptions of the natural course of this disease.

A Descriptive Study on the Population of Patients with Inflammatory Bowel Disease at the Veterans Affairs Caribbean Healthcare System in San Juan.

Objective: Inflammatory bowel disease (IBD) comprises a group of related conditions characterized by idiopathic inflammation of the gastrointestinal (GI) tract. Several studies have described the epidemiology of IBD in Puerto Rico (PR) but none have included the US military and Veteran population. The goal of this study was to describe the prevalence of IBD in this population as well as to describe patients' characteristics.

Treatment Failure with Direct Antiviral Agents in Patients with Hepatitis C Virus Genotype 1 Infection at the Veteran Affairs Caribbean Healthcare System in San Juan, Puerto Rico.

Objective: We performed a descriptive study of patients who have failed to DDAs in our Veteran population. The primary outcome of this study is to describe the clinical profile of these patients and to evaluate their respective resistance mutation panel.

Methods: This investigation is a descriptive retrospective study of patients with chronic hepatitis C between the ages of 21 to 89 years from the Veteran Affairs Caribbean Healthcare System in P.

Ombitasvir/paritaprevir/ritonavir and dasabuvir±ribavirin for chronic HCV infection in US veterans with psychiatric disorders.

Hepatitis C virus (HCV) infections are more common among US veterans receiving care through Veterans Affairs (VA) Medical Centers than among the general population. Historically, HCV therapies had lower efficacy rates in VA patients, possibly due to common comorbidities such as psychiatric disorders and substance abuse. The direct-acting antivirals ombitasvir/paritaprevir/ritonavir and dasabuvir (OBV/PTV/r+DSV)±ribavirin (RBV) are approved in the US for HCV genotype 1 (GT1)-infected adults with or without cirrhosis.

Anti-Hu-Mediated Paraneoplastic Chronic Intestinal Pseudo-Obstruction Arising From Small Cell Prostate Cancer.

Chronic intestinal pseudo-obstruction is a rare syndrome with high morbidity and mortality. The pathophysiology is not well understood, although it is postulated that it involves some sort of neuropathic and/or myopathic dysfunction resulting in intestinal dysmotility. We present the first case of chronic intestinal pseudo-obstruction secondary to a paraneoplastic syndrome associated with a primary small cell prostate cancer.

Conundrum of a Large Bowel Neoplasm: Collision Tumor.

A 79-year-old Hispanic man was admitted to the intensive care unit with symptomatic iron-deficiency anemia and watery diarrhea. Radiological images revealed diffuse colonic wall thickening, a soft-tissue fullness in the ascending colon, and multiple mesenteric lymphadenopathies. Colonoscopy showed multiple aphthous ulcers throughout the colon and a large deep ulcer with irregular raised borders in the rectosigmoid area.

Neither 10- nor 14-Day Sequential Treatment is better than Standard Triple Therapy for Helicobacter Pylori Eradication.

Objective: Helicobacter pylori is a bacterial pathogen associated with chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa associated lymphoid tissue lymphoma. Current treatment guidelines support a 7- to 14-day, triple-drug protocol consisting of a proton-pump inhibitor (PPI), clarithromycin, and either amoxicillin or an imidazole. The initial eradication rates for this regimen were 80 to 90%.

Chronic Hepatitis C: Treatment, Complications, and Long-term Outcomes in a Population of Latino Veterans.

Objective: Chronic hepatitis C (CHC) is a major public health problem in Puerto Rico. It is the most common cause of chronic liver disease and the most frequent indication for liver transplantation in the United States. Our main objectives were to estimate the seroprevalence of CHC infection, to describe the demographic and histological parameters of the infection in our sample population, and to evaluate the treatment outcomes in Puerto Rican veterans.

The Perils of Diagnosing and Treating Overlap Syndrome.

Autoimmune hepatitis (AIH) may present with clinical, laboratory abnormalities and histological features suggestive of primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC). These variants of AIH are known as overlap syndromes. We present a case of a 62 year-old-male who presented with altered liver function tests, anemia and unintentional weight loss.

Epiploic Appendagitis, an Uncommon Cause of Abdominal Pain: A Case Series and Review of the Literature.

Objective: Epiploic appendagitis (EA) is a rare entity caused by the inflammation of the appendix epiploica. It is a benign and self-limited condition presenting as acute onset abdominal pain. The inaccurate diagnosis of EA can lead to unnecessary hospitalization, antibiotic therapy, and surgery.

A Comparison of Brunt's Criteria, the Non-Alcoholic Fatty Liver Disease Activity Score (NAS), and a Proposed NAS Scoring that Includes Fibrosis in Non-Alcoholic Fatty Liver Disease Staging.

Objective: The aim of this study was to determine the prevalence of NASH in veterans with metabolic syndrome and compare histologic grading using the Brunt criteria, the NAFLD activity score (NAS), and a proposed NAS scoring system that has been modified to include fibrosis staging.

Methods: Veterans with metabolic syndrome, hepatic steatosis, and elevated ALT and AST levels and who underwent liver biopsies from 2004 through 2010 were included in this study. Biopsies were evaluated by a single hepatopathologist.

Eosinophilic Liver Infiltration.

Eosinophilic liver infiltration is a commonly encountered focal eosinophil-related inflammation with or without necrosis, which can be seen on computed tomography (CT) in the presence of peripheral eosinophilia. Although this entity has a relatively benign course, it is related to numerable conditions for which diagnosis may be challenging and requires substantial diagnostic work-up for proper management and care of the underlying disease. We report a case of a 60-year-old man who presented with a 1-week history of right upper quadrant abdominal pain with multiple ill-defined liver hypodensities associated with significant eosinophilia.

Cannabinoid Hyperemesis Syndrome: A Paradoxical Cannabis Effect.

Despite well-established antiemetic properties of marijuana, there has been increasing evidence of a paradoxical effect in the gastrointestinal tract and central nervous system, given rise to a new and underrecognized clinical entity called the Cannabinoid Hyperemesis Syndrome. Reported cases in the medical literature have established a series of patients exhibiting a classical triad of symptoms: cyclic vomiting, chronic marijuana use, and compulsive bathing. We present a case of a 29-year-old man whose clinical presentation strongly correlates with cannabinoid hyperemesis syndrome.

Primary Enteropathy-Associated T-Cell Lymphoma Type 2: An Emerging Entity?

Intestinal T-cell lymphoma is a rare hematological malignancy that can present as primary intestinal lymphoma or as a manifestation of systemic disease. Primary involvement accounts for approximately 0.1% to 0.

Type 2 diabetes mellitus and colorectal neoplasia risk in Hispanics: a case-control study.

Aims: There is inconclusive evidence regarding the potential link between diabetes mellitus (DM) and colorectal cancer (CRC). Associations between type 2 DM and colorectal neoplasia (CRN; colorectal cancer and/or adenomas) have not been well studied in Hispanics, an ethnic minority at high risk for type 2 DM. This study aims to assess the association between type 2 DM and CRN in Hispanics.

Small cell neuroendocrine carcinoma of rectum with associated paraneoplastic syndrome: a case report.

Neuroendocrine carcinomas of the colon and rectum comprise fewer than 1% of all colorectal cancers. These aggressive tumors generally have a poor prognosis compared to that associated with colorectal adenocarcinoma. We describe herein the case of a 68-year-old female presenting with a bleeding rectal mass involving the anal canal, which case was associated with hyponatremia due to inappropriate serum levels of antidiuretic hormone.