Medical Specialties Commons^™

A Complex Case Of Tracheoesophageal Fistula Following Chemoradiation And Esophagectomy, Mujtaba Moazzam, Usman Bin Hameed, Fady Banno, Rocco Sbrocca, Ramona M. Berghea

Conference Presentation Abstracts

Tracheoesophageal fistula (TEF) is a pathological connection between the trachea and esophagus. It is a rare but serious complication following esophagectomy, particularly in patients who have undergone concurrent radiation therapy, with rates of 5-15%. TEFs often manifest with severe complications such as malnutrition, infections, and life-threatening bleeding, making them exceptionally difficult to manage. This case report highlights a rare presentation of TEF in a patient with esophageal adenocarcinoma treated with multimodal therapy. A 45-year-old male with stage III esophageal adenocarcinoma underwent concurrent chemoradiation, esophagectomy, and immunotherapy. Subsequent oligometastatic disease required further treatment, including radiofrequency ablation and Keytruda maintenance. The patient …

Pericardial Effusion Of Uncommon Origin: A Diagnostic Journey, Tannoz Norouzi, Carol Lima, Sayf Al-Katib

Conference Presentation Abstracts

Tuberculous (TB) pericarditis is a rare yet serious form of extrapulmonary tuberculosis, characterized by a diverse clinical presentation and the potential to occur as an isolated extrapulmonary manifestation. In developed countries, tuberculosis is a rare cause of pericarditis, contributing to less than 5% of pericardial effusion cases and an even smaller percentage of constrictive pericarditis cases. This case describes a 27-year-old male from Mali with no significant medical history presenting with progressive fatigue, shortness of breath, and palpitations over one year. Family history revealed sudden cardiac death in his father in his 30s. Physical examination and initial investigations, including echocardiography, …

A Case Of Orbital Apex Syndrome And Mucormycosis In Undiagnosed Diabetes, Basant Sanad, Deena Sukhon, Merzia Subhan, Mamon Tahhan

Conference Presentation Abstracts

Latent Autoimmune Diabetes in Adults (LADA) is a slowly progressive and indolent condition often characterized by nonspecific symptoms at onset, which can result in delayed diagnosis and the development of severe complications. We report a case presenting with HHS/DKA, left orbital apex syndrome due to invasive fungal sinusitis, and multiple neuropathies. Despite aggressive surgical debridement, antifungal therapy, and ongoing ophthalmologic monitoring, he remains at risk for further complications, including potential orbital exenteration. A 45-year old male who has not sought medical care in the past 20 years and has no significant past medical history presented with progressive bilateral leg pain …

Reexploring The Stress Trial: Subgroup Postoperative Outcomes Following Methylprednisolone For Infant Heart Surgery, Sudeep D Sunthankar, Kevin D Hill, Jeffrey P Jacobs, H Scott Baldwin, Marshall L Jacobs, Jennifer S Li, Eric M Graham, Ashraf M Resheidat, Venugopal Amula, Mark S Bleiweis, Eric L Wald, Pirooz Eghtesady, John P Scott, Brett R Anderson, Michael F Swartz, Alexis Benscoter, William Ravekes, Prince J Kannankeril

Faculty, Staff and Students Publications

Objective Assess the association between intraoperative methylprednisolone and specific postoperative outcomes among subgroups undergoing infant heart surgery.

Design: Subpopulation analyses of The Steroids to Reduce Systemic Inflammation after Infant Heart Surgery trial, a double-blind randomized placebo-controlled trial.

Setting: 24 congenital heart centers.

Patients: Infants (< 1 year old) undergoing heart surgery with cardiopulmonary bypass. Patients stratified by Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery Congenital Heart Surgery (STAT) Mortality Category, age, gestational age, and presence of chromosomal or syndromic diagnosis (CSD).

Interventions: Methylprednisolone (30 mg/kg) versus placebo administered into cardiopulmonary bypass pump-priming fluid.

Measurements and main results: Outcomes included death, heart transplantation, mechanical circulatory support, reinterventions, and hospital length of stay. Ranked composite outcome (death, transplant, or one of 13 major complications) was compared between placebo and methylprednisolone for each subgroup using the win ratio. Methylprednisolone …

Examining Demographic, Geographic, And Temporal Patterns Of Melanoma Incidence In Texas From 2000 To 2018: Retrospective Study, Kehe Zhang, Madison M Taylor, Jocelyn Hunyadi, Hung Q Doan, Adewole S Adamson, Paige Miller, Kelly C Nelson, Cici Bauer

Faculty, Staff and Student Publications

Background: Melanoma currently ranks as the fifth leading cancer diagnosis and is projected to become the second most common cancer in the United States by 2040. Melanoma detected at earlier stages may be treated with less-risky and less-costly therapeutic options.

Objective: This study aims to analyze temporal and spatial trends in melanoma incidence by stage at diagnosis (overall, early, and late) in Texas from 2000 to 2018, focusing on demographic and geographic variations to identify high-risk populations and regions for targeted prevention efforts.

Methods: We used melanoma incidence data from all 254 Texas counties from the Texas Cancer Registry (TCR) …

Covid 19 And Its Widespread Effects On Autoimmune Disease, Jessica Ngo, Michelle Jankowski, Matthew Sims, Dwayne Baxa

Conference Presentation Abstracts

COVID-19 has disproportionately affected racial and ethnic minority groups and immunocompromised groups, including those with autoimmune diseases. Studies have shown that African American, Hispanic, and Asian American individuals have higher risk of COVID-19 positivity and ICU admissions. SARS-CoV-2 shares numerous similarities with autoimmune diseases in its symptomology and ability to dysregulate the immune response. This study seeks to investigate differences in COVID-related outcomes between patients with autoimmune diseases and the general population. Methods A multi-center retrospective study was conducted with data from the EPIC database at Corewell Health System in Michigan from December 2019 to November 2021. Variables collected included …

Analysis Of Myositis Development In Adults And Children With Inflammatory Bowel Disease, Yu Rim Park, Jamal Kriem

Conference Presentation Abstracts

Background/Objective Inflammatory bowel disease (IBD) is an autoimmune disorder that can present with a wide range of clinical manifestations spanning multiple organ systems. Myositis in patients diagnosed with IBD is an uncommon presentation, and the pathophysiology in this population is not well studied. Given the lack of research surrounding the natural history of myositis in IBD patients, we decided to investigate the demographics and medication use that may potentially serve as predictors of symptom development. We hypothesized increased rates of myositis development in patients on TNF-alpha inhibitors given anecdotal evidence in clinical practice and literature review of several clinical vignettes …

Crispr/Ncas9-Edited Cd34+ Cells Rescue Mucopolysaccharidosis Iva Fibroblasts Phenotype, Angélica María Herreno-Pachón, Andrés Felipe Leal, Shaukat Khan, Carlos Javier Alméciga-Díaz, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Mucopolysaccharidosis (MPS) IVA is a bone-affecting lysosomal storage disease (LSD) caused by impaired degradation of the glycosaminoglycans (GAGs) keratan sulfate (KS) and chondroitin 6-sulfate (C6S) due to deficient N-acetylgalactosamine-6-sulfatase (GALNS) enzyme activity. Previously, we successfully developed and validated a CRISPR/nCas9-based gene therapy (GT) to insert an expression cassette at the AAVS1 and ROSA26 loci in human MPS IVA fibroblasts and MPS IVA mice, respectively. In this study, we have extended our approach to evaluate the effectiveness of our CRISPR/nCas9-based GT in editing human CD34+ cells to mediate cross-correction of MPS IVA fibroblasts. CD34+ cells were electroporated with the CRISPR/nCas9 system, …

Artificial Intelligence-Based Virtual Staining Platform For Identifying Tumor-Associated Macrophages From Hematoxylin And Eosin-Stained Images, Arpit Aggarwal, Mayukhmala Jana, Amritpal Singh, Tanmoy Dam, Himanshu Maurya, Tilak Pathak, Sandra Orsulic, Kailin Yang, Deborah Chute, Justin A Bishop, Farhoud Faraji, Wade M Thorstad, Shlomo Koyfman, Scott Steward, Qiuying Shi, Vlad Sandulache, Nabil F Saba, James S Lewis, Germán Corredor, Anant Madabhushi

Faculty, Staff and Students Publications

Background: Virtual staining is an artificial intelligence-based approach that transforms pathology images between stain types, such as hematoxylin and eosin (H&E) to immunohistochemistry (IHC), providing a tissue-preserving and efficient alternative to traditional IHC staining. However, existing methods for translating H&E to virtual IHC often fail to generate images of sufficient quality for accurately delineating cell nuclei and IHC+ regions. To address these limitations, we introduce VISTA, an artificial intelligence-based virtual staining platform designed to translate H&E into virtual IHC.

Methods: We applied VISTA to identify M2-subtype tumor-associated macrophages (M2-TAMs) in H&E images from 968 patients with HPV+ oropharyngeal squamous cell …

Longitudinal Profiling Of Circulating Tumor Dna Reveals The Evolutionary Dynamics Of Metastatic Prostate Cancer During Serial Therapy, Yuehui Zhao, Naveen Ramesh, Ping Xu, Emi Sei, Min Hu, Shanshan Bai, Patricia Troncoso, Ana M Aparicio, Christopher J Logothetis, Paul G Corn, Nicholas E Navin, Amado J Zurita

Faculty, Staff and Student Publications

Treatment decisions in metastatic castration-resistant prostate cancer are mostly guided by clinical variables, but efforts to molecularly monitor the disease remain hampered by challenges in acquiring tumor tissue repeatedly. In this study, we simultaneously profiled the genome copy number and exome in longitudinal plasma circulating tumor DNA (ctDNA) acquired before, during, and upon progression to serial treatments with androgen signaling inhibitors and taxane chemotherapy from 60 patients with metastatic castration-resistant prostate cancer (2-10 samples per patient). The genomic data were used to delineate the clonal substructure and evolutionary dynamics of each patient, and an evolutionary dynamic index was developed to …

Efficacy And Safety Of Larotrectinib In Patients With Trk Fusion Gastrointestinal Cancer, Changsong Qi, Lin Shen, Thierry Andre, Hyun Cheol Chung, Timothy L Cannon, Elena Garralda, Antoine Italiano, Damian T Rieke, Tianshu Liu, Domnita-Ileana Burcoveanu, Natascha Neu, Chiara E Mussi, Rui-Hua Xu, David S Hong, Alexander Drilon, Jordan Berlin

Faculty, Staff and Student Publications

Background: Larotrectinib is the first-in-class, highly selective TRK inhibitor with demonstrated efficacy in various TRK fusion solid tumours. We report the efficacy and safety of larotrectinib in patients with TRK fusion gastrointestinal (GI) cancer.

Methods: Patients with TRK fusion GI cancer from NAVIGATE (NCT02576431) were included. Response was independent review committee (IRC)-assessed per RECIST v1.1.

Results: As of July 2023, 44 patients were enrolled. Tumour types included colorectal (CRC; n = 26), pancreatic (n = 7), cholangiocarcinoma (n = 4), gastric (n = 3), and one each of appendiceal, duodenal, oesophageal and hepatic cancers. Of the 26 patients …

Profound Endocarditis Resulting In Recurrent Fatigue, Shawn Matharu, Majid Qazi

Conference Presentation Abstracts

A 46 year-old female with past medical history of congenital aortic stenosis status post bovine bioprosthetic valve replacement and an ascending aortic aneurysm repair 13 years prior to presentation presented with fatigue and generalized weakness. The patient also had a history of non-obstructive coronary artery disease, hypertension, and HFpEF. She recently was diagnosed with infectious mononucleosis 3 weeks prior. In the 1 month prior to her index presentation she had two prior admissions for respiratory symptoms. On physical exam, the patient had a 4/6 holosystolic murmur. Her laboratory markers revealed a profound leukocytosis, mild anemia, a mild troponinemia, hypokalemia, and …

Coronary Subclavian Steal Syndrome: A Rare But Deadly Complication In Post-Cabg Patients, Hazem Alakhras, Parvathy Sankar, James Goldstein

Conference Presentation Abstracts

Coronary Subclavian Steal Syndrome (CSSS) is a rare but serious complication of coronary artery bypass grafting (CABG). It occurs when the left anterior descending (LAD) coronary artery is bypassed from the left subclavian artery (LSA) using the left internal mammary artery (LIMA). The syndrome arises due to stenosis of the LSA, leading to reduced blood flow through the LIMA. This triggers retrograde flow from the LIMA to the distal LSA, resulting in myocardial ischemia despite patent grafts. Clinical presentation can vary from asymptomatic cases to severe manifestations such as new-onset heart failure or acute coronary syndrome (ACS). A 79-year-old female …

Double Trouble: A Case Of Persistent Left-Sided Superior Vena Cava, Lark Steafo, Kateryna Strubchevska, Olena Strubchevska, Marko Kozyk, Shazil Mahmood, Steven Timmis

Conference Presentation Abstracts

A persistent left-sided superior vena cava (PLSVC) is a rare vascular anomaly where the left superior cardinal vein fails to regress during embryogenesis, resulting in an additional venous structure that drains into the right atrium, often via the coronary sinus. It is usually asymptomatic but may be discovered incidentally during imaging or procedures, but its presence can have implications for central venous access and pacemaker placement. Our case features an 82-year-old male with a past medical history of coronary artery disease, remote esophageal cancer, hypertension, hyperlipidemia, and tobacco use disorder, referred to the emergency department from his primary care doctor’s …

Case Of Coxsackie B Perimyocarditis Presenting With Hemoptysis, Respiratory Failure, And New-Onset Heart Failure, Maya Jaradi, Nicole Marijanovich

Conference Presentation Abstracts

Perimyocarditis describes inflammation of the pericardium and myocardium. Most cases are idiopathic, however when infectious causes are present, it is typically due to a virus such as coxsackievirus, adenovirus, herpesvirus, or echovirus amongst others. Clinical features vary from mild, self-limiting symptoms to cardiogenic shock and death. We will discuss a unique case of viral perimyocarditis presenting with hemoptysis, respiratory failure, and new-onset heart failure with severely reduced ejection fraction. A 59-year-old female with a history of asthma, hypertension, and recently treated pneumonia presented with acute-onset headache, fatigue, and shortness of breath. On admission, she was severely hypertensive in the 200s/90s. …

Hypereosinophilic Syndrome In A Patient With Diffuse B-Cell Lymphoma, Keaton Schmitz, Francisco R. Davila, Aagamjit Singh, Jamie Satow

Conference Presentation Abstracts

Introduction Hypereosinophilic syndrome (HES) is a rare condition characterized by eosinophil-mediated organ damage and a peripheral eosinophil count >1.5x10⁹/L, with varied etiologies classified as primary, secondary, idiopathic, or organ-restricted. Cardiac involvement, often termed Loeffler’s endocarditis (LE), is a rare but severe manifestation of HES. Neoplastic causes of HES are typically linked to myeloid neoplasms, with limited literature on an association with B-cell lymphomas. We report a unique case of HES and LE in a patient with diffuse large B-cell lymphoma (DLBCL). Case description A 78-year-old female with a past medical history of DLBCL, coronary artery disease, and cryptogenic strokes presented …

Genomic Characterization Of High-Grade Serous Ovarian Carcinoma Reveals Distinct Somatic Features In Black Individuals, Katherine A Lawson-Michod, Jeffrey R Marks, Lindsay J Collin, David A Nix, Natalie R Davidson, Chad D Huff, Yao Yu, Aaron Atkinson, Courtney E Johnson, Lucas A Salas, Lauren C Peres, Casey S Greene, Joellen M Schildkraut, Jennifer A Doherty

Faculty, Staff and Student Publications

Black individuals experience worse survival after a diagnosis of high-grade serous ovarian carcinoma (HGSC) than White individuals and are underrepresented in ovarian cancer research. To date, the understanding of the molecular and genomic heterogeneity of HGSC is based primarily on the evaluation of tumors from White individuals. In the present study, we performed whole-exome sequencing on HGSC samples from 211 Black patients to identify significantly mutated genes and characterize mutational signatures, assessing their distributions by gene expression subtypes. The occurrence and frequency of somatic mutations and signatures by self-reported race were compared with historic data from The Cancer Genome Atlas …

A Tobacco Treatment Training Program Expands The Number Of Healthcare Providers Trained To Use Evidence-Based Practices And Methods, Alex Hurst, Maher Karam-Hage, Jennifer Cofer, Mehwish Javaid, Diane Beneventi, Janice Blalock, Tiffany Winter, Paul M. Cinciripini, Ernest Hawk

Advances in Cancer Education and Quality Improvement

Tobacco-use disorder remains a global health challenge, despite declining rates, and is a leading cause of morbidity and mortality, especially among special populations that disproportionally do not have access to comprehensive treatment services. The lack of trained providers and slow dissemination of new tobacco treatment knowledge are obstacles to accessing comprehensive evidence-based treatments. Less is known about the impact of specialized training programs on healthcare professionals' ability to effectively treat tobacco use. This paper reports on the evaluation of the tobacco treatment training program, training methodology, and the demographics of the specialists trained.

MD Anderson’s Tobacco Treatment Training Program (TTTP) …

In-Person And Virtual Adaptation Of An Interprofessional Palliative Care Communications Skills Training Course For Pediatric Oncology Clinicians, Karen Moody, Clark R. Andersen, Robert M. Arnold, Julie Bradley, Allie Carter, Lauren Draper, Timothy Garrington, Jonathan B. Gill, Douglas J. Harrison, Masanori Hayashi, Amy Heaton, Cynthia Holladay, Alex Lion, Alakh Rajan, Beatriz N. Rozo, Daniel V. Runco, Shermini Saini, Laura K. Salvador, Kathryn Sutton, Verna Ferguson

Advances in Cancer Education and Quality Improvement

Introduction

Empathic communication is crucial for clinicians when discussing palliative and end-of-life (PC/EOL) care with parents of children with cancer. Unfortunately, many parents report inadequate communication at these distressing times. This study evaluates the communication skills training (CST) clinicians received to deliver a PC/EOL communication intervention as part of a multi-site randomized-controlled trial (RCT). Training was provided using an in-person format and then adapted to a virtual platform to accommodate remote learners.

Methods

Clinicians were trained in dyads (one physician and one nurse [RN] or advanced practice provider [APP]) over 3 days (in-person or virtually). Four pediatric oncology cases were …

Rising Use Of Immune Checkpoint Inhibitors And The Escalating Burden Of Gastrointestinal And Hepatic Toxicities: A Nine-Year Analysis, Donghyun Ko, Do Han Kim Md, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Francis F. Fadi, Jana G. Hashash, Francis A. Farraye, Paul T. Kroner Md

Posters

The advent of immune checkpoint inhibitors (ICIs), including programmed death 1 (PD-1), PD-L1, and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitors, has revolutionized cancer therapeutics, markedly improving survival in various malignancies. However, their expanding utilization has been paralleled by the emergence of immune-related adverse events (irAEs), particularly gastrointestinal (GI) and hepatic toxicities, which pose significant challenges in clinical practice. These toxicities can manifest as a spectrum of conditions, from mild transient symptoms to severe, life-threatening complications, necessitating a better understanding of their prevalence and trends. This study aims to evaluate the temporal changes in ICI use and associated GI and hepatic …

Low Dose Aspirin Is Associated With Improved 30-And 92-Day Outcomes In Patients With Acute Pancreatitis: A Multinational Multicenter Analysis, Do Han Kim Md, Donghyun Ko Md, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Frank J. Lukens Md, Paul T. Kroner Md

Posters

Currently, no medications are known to formally treat or prevent acute pancreatitis (AP). Significant attention has been devoted to aspirin (ASA), with rodent models showing that it is associated with decreased inflammatory cytokine levels and protects against acinar cell necrosis. Current human studies, which are limited to retrospective inpatient outcomes only on the index hospitalization for AP, do suggest that patients on ASA have improved outcomes. The aim of our study was to explore de 30- and 90- day outcomes of patients with AP on long-term ASA use.

Long-Term Use Of Oral Factor X(A) Inhibitors Is Associated With Increased Rates Of Pancreatic Necrosis At 30- And 90-Days In Patients With Acute Pancreatitis: A Multinational Multicenter Analysis, Do Han Kim Md, Donghyun Ko, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Frank J. Lukens Md, Paul T. Kroner Md

Posters

The aim of this study is to explore the association between use of long-term anticoagulation with FXaI and the odds of pancreatic necrosis in patients with AP using a large multinational database.

Chronic Antiplatelet Agent Use Is Associated With Decreased 90-Day Morbidity And Mortality In Patients With Acute Pancreatitis, Do Han Kim Md, Donghyun Ko, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Frank J. Lukens Md, Paul T. Kroner Md

Posters

The aim of this study is to explore the association between the use of antiplatelets and outcomes of patients with AP using a large multinational database.

Acute Pancreatitis With Acute Kidney Injury Is Associated With Worse 30 And 90-Day Outcomes: A Multinational Multicenter Analysis, Donghyun Ko, Do Han Kim Md, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Frank J. Lukens Md, Paul T. Kroner Md

Posters

Acute kidney injury (AKI) in patients with acute pancreatitis (AP) has been consistently shown to impact clinical outcomes and is a marker of organ dysfunction, being a primary indicator and driver of disease severity. The cornerstone of management of AP is aggressive intravenous fluid administration, and AKI has traditionally been a surrogate measure of the adequacy of volume repletion and is even recommended by the current ACG guidelines to be monitored in 6-hour intervals for 24-48 hours from presentation. While having been proven to be a factor of paramount importance on prior studies, the aim of our study is to …

Evolocumab Is Associated With Lower Mortality When Compared To Statin In Masld/Mash Patients: A Multinational Analysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Cristina H. Makarian, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Evolocumab is typically used as an add-on or replacement therapy for patients with dyslipidemia who are already on the maximum tolerated dose of statins or are intolerant to statins. While statins are effective in lowering lipid levels and have been shown to improve liver-related outcomes and reduce major adverse cardiovascular events (MACE), statin intolerance is increasingly encountered with their widespread use. The aim of our study is to compare the benefits of using evolocumab as monotherapy versus statins as monotherapy in patients with metabolic-dysfunction-associated steatotic liver disease (MASLD) and metabolic-dysfunction-associated steatohepatitis (MASH).

Rectal Indomethacin Decreases Post-Ercp Pancreatitis In Elderly Patients Without Increasing The Risk Of Acute Kidney Injury, Do Han Kim Md, Donghyun Ko Md, Jose A. Porres, Wilhelm S. Basegoda Md, Carlos Eilzondo-Alatorre Md, Luis M. Nieto Md, Miguel Salazar Md, Paul T. Kroner Md, Pedro Palacios Argueta Md, Frank J. Lukens Md

Posters

This study examines the association of use of rectal indomethacin with clinical outcomes in elderly patients undergoing ERCP using a large population-based multinational database.

Valproate Use Is Associated With Higher Mortality And Hepatic Decompensationin Patients With Masld/ Mash: A Multinational Analysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Valproate is a widely used anti-seizure medication for treating epilepsy. However, it significantly impacts lipid metabolism by interfering with the beta-oxidation pathway of fatty acids in mitochondria. This disruption is expected to accelerate the progression of metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH) in patients on chronic valproate therapy. The aim of this study is to determine whether the chronic use of valproate increases the risk of liver-related and cardiovascular events

History Of Bariatric Surgery Is Not Associated With Worse Clinical Outcomes At 5 Years In Patients Who Undergo Liver Transplantation, Do Han Kim Md, Donghyun Ko, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Klaus E. Monkemuller, Paul T. Kroner Md

Posters

This study explores and compares outcomes of LT alone with LT in patients with a prior history of RYGB or SG, using a large multinational database.

Sglt-2 Inhibitor Use Is Associated With Lower Mortality In Patients With Alcoholic Cirrhosis And Type 2 Diabetes Mellitus: A Multinational Analysis, Do Han Kim Md, Donghyun Ko, Jose A. Porres, Wilhelm S. Basegoda Md, Cristina H. Makarian, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

In our study, we aimed to investigate whether SGLT2 inhibitors are associated with a reduced risk of all-cause mortality, liver-related events, and cardiovascular outcomes in patients with alcoholic cirrhosis and T2DM.

Pancreatic Ascites: Update On Diagnosis And Management, Lefika Bathobakae, Heba Farhan, Derya Mücahit, Dina Rohira, Kashyap Chauhan, Yana Cavanagh, Walid Baddoura, Derick J Christian

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Pancreatic ascites is a rare condition characterized by the accumulation of high-amylase ascitic fluid in the peritoneal cavity. This condition is often associated with chronic pancreatitis, pancreatic trauma, or pseudocyst rupture. Because of its rarity and ill-defined clinical presentation, pancreatic ascites is often a diagnostic and therapeutic challenge in clinical practice. The current diagnostic criteria include an amylase level >1000 mg/dL, a protein level >3 g/dL, and a serum ascites albumin gradient < 1.1 g/dL. The clinical features vary, but may include progressive abdominal distension, diffuse abdominal pain, weight loss and peritonitis. The management of pancreatic ascites remains controversial, and there is no consensus regarding the optimal approach. Conservative medical management, which includes nutritional support, pain control, therapeutic paracentesis and the use of somatostatin analogs, has been associated with a high failure rate and significant morbidity. Interventional therapies, such as surgery and endoscopic transpapillary stenting, have shown more promising outcomes. However, the choice between these methods is still debated, with some advocating for endoscopic approaches, because of their minimally invasive nature and reduced morbidity compared with surgical options. Endoscopic approaches remain underutilized in practice, probably because of the need for repeated interventions, the potential risks associated with endoscopic retrograde cholangiopancreatography, or a lack of skilled personnel. Although they show significant perioperative morbidity and mortality, surgical options provide definitive resolution of pancreatic ascites. Herein, we provide an updated review of pancreatic ascites, highlighting advances in diagnostic techniques and therapeutic approaches, and summarizing insights from recent clinical cases and retrospective studies.