Medicine and Health Sciences Commons^™

Multicenter, Randomized Study To Optimize Bowel For Colon Capsule Endoscopy, David Kastenberg, Wilmot C. Burch Jr, David P. Romeo, Pankaj K. Kashyap, David C. Pound, Neophytos Papageorgiou, Ignacio Fernández-Urien Sainz, Carly E. Sokach, Douglas K. Rex

Division of Gastroenterology and Hepatology Faculty Papers

AIM To assess the cleansing efficacy and safety of a new Colon capsule endoscopy (CCE) bowel preparation regimen. METHODS This was a multicenter, prospective, randomized, controlled study comparing two CCE regimens. Subjects were asymptomatic and average risk for colorectal cancer. The second generation CCE system (PillCam^® COLON 2; Medtronic, Yoqneam, Israel) was utilized. Preparation regimens differed in the 1^st and 2^nd boosts with the Study regimen using oral sulfate solution (89 mL) with diatrizoate meglumine and diatrizoate sodium solution (“diatrizoate solution”) (boost 1 = 60 mL, boost 2 = 30 mL) and the Control regimen oral sulfate …

A Retrospective Study Evaluating Endoscopic Ultrasound-Guided Drainage Of Pancreatic Fluid Collections Using A Novel Lumen-Apposing Metal Stent On An Electrocautery Enhanced Delivery System., Douglas G. Adler, Linda Jo Taylor, Raza Hasan, Ali A. Siddiqui

Division of Gastroenterology and Hepatology Faculty Papers

OBJECTIVES: To report the safety and clinical efficacy with the novel lumen-apposing metal stent (LAMS) with an electrocautery enhanced delivery system for the drainage of pancreatic fluid collections (PFCs).

METHODS: This was a retrospective analysis of all consecutive patients with PFCs who underwent endoscopic ultrasound (EUS)-guided drainage using the LAMS with an electrocautery enhanced delivery system in 2 US centers.

RESULTS: Thirteen patients with PFCs (69% with walled-off necrosis [WON]) underwent drainage using the study device. Successful stent placement was accomplished in all patients. Direct endoscopic necrosectomy was carried out in all nine patients with WON complete resolution of the …

Obstetricians' And Gynecologists' Knowledge, Education, And Practices Regarding Chronic Hepatitis B In Pregnancy., Bolin Niu, Dina Halegoua-De Marzio, Jonathan M. Fenkel, Steven K. Herrine

Division of Gastroenterology and Hepatology Faculty Papers

Background: In pregnant women with high viral loads, third-trimester initiation of antiviral agents can reduce the risk of vertical transmission. We aimed to assess obstetricians' and gynecologists' (OB-GYN) knowledge and clinical practice when treating pregnant women with chronic hepatitis B virus (HBV).

Methods: All program directors (PDs) from 250 US OB-GYN residency programs were invited to anonymously complete an 18-item questionnaire. Descriptive statistics were calculated and analyzed.

Results: A total of 323 participants responded, including both PDs (n=51, response rate 21%) and residents (n=272, response rate 11%). Responding PDs (62% university-based vs. 32% community-based) came from various practice types. All …

Comparison Of The Diagnostic Accuracy Of Three Current Guidelines For The Evaluation Of Asymptomatic Pancreatic Cystic Neoplasms., Ming-Ming Xu, Shi Yin, Ali A. Siddiqui, Ronald R. Salem, Beth Schrope, Amrita Sethi, John M. Poneros, Frank G. Gress, Jeanine M Genkinger, Catherine Do, Christian A. Brooks, John A. Chabot, Michael D. Kluger, Thomas E. Kowalski, David E. Loren, Harry Aslanian, James J. Farrell, Tamas A. Gonda

Division of Gastroenterology and Hepatology Faculty Papers

Asymptomatic pancreatic cysts are a common clinical problem but only a minority of these cases progress to cancer. Our aim was to compare the accuracy to detect malignancy of the 2015 American Gastroenterological Association (AGA), the 2012 International Consensus/Fukuoka (Fukuoka guidelines [FG]), and the 2010 American College of Radiology (ACR) guidelines.We conducted a retrospective study at 3 referral centers for all patients who underwent resection for an asymptomatic pancreatic cyst between January 2008 and December 2013. We compared the accuracy of 3 guidelines in predicting high-grade dysplasia (HGD) or cancer in resected cysts. We performed logistic regression analyses to examine …

A Multi-Institutional Consensus On How To Perform Endoscopic Ultrasound-Guided Peri-Pancreatic Fluid Collection Drainage And Endoscopic Necrosectomy., Jintao Guo, Adrian Saftoiu, Peter Vilmann, Pietro Fusaroli, Marc Giovannini, Girish Mishra, Surinder S. Rana, Sammy Ho, Jan-Werner Poley, Tiing Leong Ang, Evangelos Kalaitzakis, Ali A. Siddiqui, Jose G. De La Mora-Levy, Sundeep Lakhtakia, Manoop S. Bhutani, Malay Sharma, Shuntaro Mukai, Pramod Kumar Garg, Linda S. Lee, Juan J. Vila, Everson Artifon, Douglas G. Adler, Siyu Sun

Division of Gastroenterology and Hepatology Faculty Papers

There is a lack of consensus on how endoscopic ultrasound (EUS)-guided pseudocyst drainage and endoscopic necrosectomy should be performed. This survey was carried out amongst members of the EUS Journal Editorial Board to describe their practices in performing this procedure. This was a worldwide multi-institutional survey amongst members of the EUS Journal Editorial Board in May 2017. The responses to a 22-question survey with respect to the practice of EUS-guided pseudocyst drainage and endoscopic necrosectomy were obtained. Twenty-two endoscopists responded to the questionnaire as follows: 72.7% (16/22) were of the opinion that lumen-apposing metal stents (LAMS) should be the standard …

Role Of Differentially Expressed Microrna-139-5p In The Regulation Of Phenotypic Internal Anal Sphincter Smooth Muscle Tone., Jagmohan Singh, Ipsita Mohanty, Sankar Addya, Benjamin Philllips, Hwan Mee Yong, Steven S. An, Raymond B. Penn, Satish Rattan

Division of Gastroenterology and Hepatology Faculty Papers

The present study focused on the role of microRNA-139-5p (miRNA-139-5p) in the regulation of basal tone in internal anal sphincter (IAS). Applying genome-wide miRNA microarrays on the phenotypically distinct smooth muscle cells (SMCs) within the rat anorectrum, we identified miRNA-139-5p as differentially expressed RNA repressor with highest expression in the purely phasic smooth muscle of anococcygeus (ASM) vs. the truly tonic smooth muscle of IAS. This pattern of miRNA-139-5p expression, previously shown to target ROCK2, was validated by target prediction using ingenuity pathway (IPA) and by qPCR analyses. Immunoblotting, immunocytochemistry (ICC), and functional assays using IAS tissues and cells subjected …

Nobody Really Knows How To Perform Endoscopic Necrosectomy., Douglas G. Adler, Ali A. Siddiqui

Division of Gastroenterology and Hepatology Faculty Papers

No abstract provided.

Clostridium Septicum Aortitis With Synchronous Ascending Colon And Rectal Adenocarcinoma., Deepanshu Jain, Andrew C. Kistler, Patricia L. Kozuch

Division of Gastroenterology and Hepatology Faculty Papers

Clostridium septicum (C. septicum) aortitis is a rare condition frequently associated with colon adenocarcinoma and carries a poor prognosis. We report the case of a 66-year-old man who presented with abdominal pain, blood in the stool, fever and chills. Laboratory tests were significant for leukocytosis and microcytic anemia. Abdominal imaging revealed a right colon mass and aortitis. Colonoscopy confirmed the right colon mass and also discovered a rectal mass, both adenocarcinomas. Treatment consisted of antibiotics, aortic repair, right hemi-colectomy and later trans-anal excision of the rectal mass. Blood cultures and the aortic specimen grew C. septicum. The patient improved and …

Feasibility, Safety, And Outcomes Of A Single-Step Endoscopic Ultrasonography-Guided Drainage Of Pancreatic Fluid Collections Without Fluoroscopy Using A Novel Electrocautery-Enhanced Lumen-Apposing, Self-Expanding Metal Stent., Joseph Yoo, Linda Yan, Raza Hasan, Sanaa Somalya, Jose Nieto, Ali A. Siddiqui

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND AND OBJECTIVES: There are currently limited data available regarding the safety of endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs) using the lumen-apposing metal stent without fluoroscopic guidance. This study aims to evaluate clinical outcomes and safety of EUS-guided drainage of PFC using the electrocautery-enhanced lumen-apposing metal stents (EC-LAMSs) without fluoroscopic guidance.

METHODS: We conducted a retrospective study on patients with symptomatic PFC who underwent EUS-guided drainage using EC-LAMS without fluoroscopy. All patients were followed clinically until resolution of their PFC. Technical success (successful placement of EC-LAMS), number of patients who achieved complete resolution of PFC without additional …