Concomitant Achalasia and Barrett's Esophagus: A Rare Coincidence.

The pathophysiologies of achalasia and gastroesophageal reflux disease with Barrett's esophagus are highly distinct, though the clinical signs and symptoms of both are highly overlapped. The concomitant development of both achalasia and Barrett's esophagus is rare. We describe a case of a patient with a concomitant diagnosis of both pathologies and further explain the epidemiology of carrying both diseases simultaneously.

Kupffer cell diversity maintains liver function in alcohol-associated liver disease.

Background And Aims: Liver macrophages are heterogeneous and play an important role in alcohol-associated liver disease (ALD) but there is limited understanding of the functions of specific macrophage subsets in the disease. We used a Western diet alcohol (WDA) mouse model of ALD to examine the hepatic myeloid cell compartment by single cell RNAseq and targeted KC ablation to understand the diversity and function of liver macrophages in ALD.

Approach And Results: In the WDA liver, KCs and infiltrating monocytes/macrophages each represented about 50% of the myeloid pool.

Persistent Apoptotic Enteropathy in an Individual With Marginal Cell Lymphoma.

Apoptotic enteropathy is a histological finding of increased crypt apoptosis that is commonly associated with diarrhea. Several etiologies for this disease state including immunodeficiency, autoimmune, infection, hereditary, checkpoint inhibitors, immunosuppressants, and immunomodulators have been previously described. We describe an extremely rare case of a patient with marginal cell lymphoma treated with bendamustine, rituximab, and obinutuzumab presenting with severe, relapsing, chronic diarrhea with persistent apoptotic enteropathy of unknown etiology, despite hematological remission and discontinuation of treatment for 1 year.

Cerebrospinal fluid AFB smear in adults with tuberculous meningitis: A systematic review and diagnostic test accuracy meta-analysis.

Background: Cerebrospinal fluid (CSF) Ziehl-Neelsen acid-fast bacilli (AFB) smear is a rapid, cheap, widely available test for tuberculous meningitis (TBM). Yet, reported test sensitivity is highly variable. We performed a systematic review and meta-analysis for CSF AFB smear vs.

Tuberculosis IRIS: Pathogenesis, Presentation, and Management across the Spectrum of Disease.

Antiretroviral therapy (ART), while essential in combatting tuberculosis (TB) and HIV coinfection, is often complicated by the TB-associated immune reconstitution inflammatory syndrome (TB-IRIS). Depending on the TB disease site and treatment status at ART initiation, this immune-mediated worsening of TB pathology can take the form of paradoxical TB-IRIS, unmasking TB-IRIS, or CNS TB-IRIS. Each form of TB-IRIS has unique implications for diagnosis and treatment.

Outcomes following Lower Extremity Amputation in Patients with Diabetes Mellitus and Peripheral Arterial Disease.

Background: Lower extremity amputations (LEAs) are projected to increase drastically in the United States. The potential effects of diabetes mellitus (DM) and peripheral arterial disease (PAD) on LEA outcomes have not been well-explored. We sought to investigate the clinical outcomes of LEA in patients with DM alone, PAD alone, and patients with concurrent DM and PAD (DM + PAD) from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample.

A Unique Presentation of a Large, Seven-segment, Spinal Epidural Abscess in a Patient with a Pleural Empyema.

Spinal epidural abscesses are insidious infections spread via hematologic, contiguous, or iatrogenic routes. On average, spinal epidural abscesses span two to four vertebral segments and are most commonly localized to the thoracic region. Fever, back pain, and neurological deficits are the most common clinical manifestations.