Hierarchical task analysis of endoscopic sleeve gastroplasty.

Background: Endoscopic sleeve gastroplasty (ESG) is a minimally invasive endoscopic weight loss procedure used to treat obesity. The long-term goal of this project is to develop a Virtual Bariatric Endoscopy (ViBE) simulator for training and assessment of the ESG procedure. The objectives of this current work are to: (a) perform a task analysis of ESG and (b) create metrics to be validated in the created simulator.

Gender differences in Barrett's esophagus and progression of disease: a systematic review and meta-analysis.

It is known that Barrett's esophagus (BE) and esophageal adenocarcinoma occur more commonly in men. What is unknown are the prevalence of BE and rates of neoplastic progression in women. Our aim was to determine the prevalence of Barrett's and its progression to esophageal cancer in women through systematic review and meta-analysis.

Optical diagnosis of colorectal polyps using novel blue light imaging classification among trainee endoscopists.

Background: Blue light imaging (BLI) has been shown to improve the characterization of colorectal polyps among the endoscopy experts. We aimed to determine if this technology could be taught to endoscopy trainees while maintaining high accuracy and interobserver agreement.

Methods: Twenty-one gastroenterology trainees (fellows) from two academic institutions participated in this prospective study.

Pembrolizumab-Induced Immune-Mediated Hepatitis and Concurrent Hepatitis B Reactivation in a Patient With Non-Small Cell Lung Cancer.

New immuno-therapeutic agents like pembrolizumab used in cancer treatment are known to cause immune-mediated hepatitis. Most of these cases are straightforward when the onset of transaminitis correlates with the introduction of the medication. This agent causing hepatitis B reactivation has been reported only once.

Bleeding After Elective Interventional Endoscopic Procedures in a Large Cohort of Patients With Cirrhosis.

Introduction: Elective therapeutic endoscopy is an important component of care of cirrhotic patients, but there are concerns regarding the risk of bleeding. This study examined the incidence, risk factors, and outcomes of bleeding after endoscopic variceal ligation (EVL), colonoscopic polypectomy, and endoscopic retrograde cholangiopancreatography with sphincterotomy in cirrhotic patients.

Methods: A cohort study of patients with cirrhosis who underwent the above procedures at a single center between 2012 and 2014 was performed.

Gallstone pancreatitis: general clinical approach and the role of endoscopic retrograde cholangiopancreatography.

Gallstones account for majority of acute pancreatitis in the Western world. Increase in number and smaller size of the stones increases the risk for biliary pancreatitis. In addition to features of acute pancreatitis, these patients also have cholestatic clinical picture.

Metastatic Mucinous Adenocarcinoma of the Cervix Presenting as Acute Hepatitis.

Cervical cancer is well known to cause metastasis in liver. Not usually they present in a pattern of acute hepatitis with the liver enzymes trending above the range of thousands. Here we present an interesting case of a patient who presented as acute hepatitis in the setting of metastatic cervical cancer to the liver.

Variations in Screening Adenoma Detection Rate by Specialty of Physicians in a Predominately African American Population.

Background: Screening colonoscopy aims to interrupt the adenoma-carcinoma sequence by removing all precancerous adenomatous polyps. Adenomatous polyp detection rate (ADR) can vary between endoscopists as well as between race, age, and risk of colorectal cancer (CRC). The purpose of this study was to compare ADR among academic gastroenterologists (A-GI), non-A-GI, and surgeons for endoscopies performed in the same endoscopic suite of a large medical center with a predominately African American (AA) population.

A case of acute liver failure due to carfilzomib in multiple myeloma.

What Is Known And Study Objective: Carfilzomib is a newer drug approved for the treatment of relapsing and refractory multiple myeloma. It has been rarely associated with acute liver failure (ALF).

Case Summary: We present a case of 58-year-old man presenting with abnormal liver function tests and subsequently diagnosed with ALF due to carfilzomib.

An Unusual Case of Recurrent Hypersensitivity Reaction Associated with Kounis-Like Acute Coronary Syndrome.

There have been multiple reports of allergic reactions associated with acute coronary syndromes. This has been classically described as Kounis syndrome. We present an unusual case of 70-year-old male with multiple prior hypersensitivity reactions and history of coronary artery bypass grafting who presented recurrent episode of severe angioedema and anaphylaxis.

Atrial fibrillation and hyperthyroidism: A literature review.

Atrial fibrillation is the most common arrhythmia worldwide with increasing frequency noted with age. Hyperthyroidism is a well-known cause of atrial fibrillation with a 16%-60% prevalence of atrial fibrillation in patients with known hyperthyroidism Ross et al. (2016).

The exception to Marriot's sign.

Differentiation of a wide complex arrhythmia can pose as a clinical challenge in the acute care setting. Two broad differentials exist including ventricular tachycardia versus supraventricular tachycardia with aberrancy, underlying bundle branch block or intrinsic conduction defect. To aid in distinguishing between supraventricular tachycardia and ventricular tachycardia, Brugada criteria is commonly used, albeit new algorithms have become more common.

A forgotten cause of wide complex tachycardia.

Wide complex tachycardia secondary to an acute overdose from TCA's is a well-documented phenomenon. In this case we present a wide complex tachycardia after clear documentation of no acute overdose, which responded to standard treatment for TCA toxicity. These findings combined with chronic electrocardiographic abnormalities were suggestive of an acute on chronic TCA toxicity.