Angiotensin-converting enzyme inhibitor therapy and colorectal cancer risk.

Background: Laboratory data suggest a role of angiotensin II in the pathogenesis of colorectal cancer (CRC). Whether angiotensin converting enzyme inhibitor (ACE-I) and/or angiotensin receptor blocker (ARB) use reduces the risk of colorectal neoplasia remains unclear. Given their widespread use, we sought to determine whether exposure to these agents would have a secondary benefit on CRC incidence.

Poor discriminatory function for endoscopic skills on a computer-based simulator.

Background: Computer-based endoscopy simulators may enable trainees to learn and develop technical skills before performing on patients. Simulators require validation as adequate models of live endoscopy before being used for training or assessment purposes.

Objective: To evaluate content and criterion validity of the CAE EndoscopyVR Simulator colonoscopy and EGD modules as predictors of clinical endoscopic skills.

Liver transplantation in patients with cystic fibrosis: analysis of United Network for Organ Sharing data.

The improved life expectancy of patients with cystic fibrosis (CF) has led to a change in the impact of liver disease on the prognosis of this population. Liver transplantation has emerged as the procedure of choice for patients with CF and features of hepatic decompensation and for intractable variceal bleeding as a major manifestation. We retrospectively reviewed the United Network for Organ Sharing database to analyze the outcomes of 55 adults and 148 children with CF who underwent liver transplantation, and we compared them to patients who underwent transplantation for other etiologies.

Lack of a discriminatory function for endoscopy skills on a computer-based simulator.

Background: Computer-based endoscopy simulators have been developed to enable trainees to learn and gain technical endoscopic skills before operating on patients. However, these simulators have not been validated as models of patient-based endoscopy. This study aimed to determine whether a computer-based simulator can accurately represent an actual esophagogastroduodenoscopy (EGD) and colonoscopy and to evaluate its ability to discriminate between varying levels of expertise in performing endoscopic procedures based on objective parameters.

Presumed corneal copper deposition and oral contraceptive use.

Purpose: To report a case of presumed bilateral corneal copper deposition secondary to oral contraceptive use.

Methods: A 23-year-old woman was referred for evaluation of bilateral corneal opacities. The location of the deposits deep in Descemet's membrane and appearance made copper deposition a likely consideration.

Incidence and prevalence of abnormal liver associated enzymes in patients with atrial fibrillation in a routine clinical care population.

Unlabelled: The prevalence of elevated liver enzymes has not been described in patients with atrial fibrillation (AF) who may be more likely to develop these abnormalities due to comorbidities and medications. As signals of liver injury lead to termination of drug development programs, an attempt to better define the background prevalence would aid in interpreting these elevations in the setting of exposure to a new drug. The aim of this study was to estimate the prevalence and incidence of alanine aminotransferase (ALT) elevations in a cohort with AF.

Therapy insight: approaching endoscopy in anticoagulated patients.

Over the past decade, the application of anticoagulant and antiplatelet agents for various cardiovascular and hematologic conditions has become more widespread. Optimal management of these agents during the periendoscopic period requires consideration, but limited prospective data mean that guidelines have largely relied on expert opinion. Elective procedures should be delayed in patients on temporary anticoagulation therapy (e.