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https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#1
Welmoed K van Deen, Arlen Spiro, A Burak Ozbay, Martha Skup, Adriana Centeno, Natalie E Duran, Precious N Lacey, Darius Jatulis, Eric Esrailian, Martijn G H van Oijen, Daniel W Hommes
BACKGROUND AND OBJECTIVES: Value-based healthcare (VBHC) is considered to be the solution that will improve quality and decrease costs in healthcare. Many hospitals are implementing programs on the basis of this strategy, but rigorous scientific reports are still lacking. In this pilot study, we present the first-year outcomes of a VBHC program for inflammatory bowel disease (IBD) management that focuses on highly coordinated care, task differentiation of providers, and continuous home monitoring...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27922855/liver-stiffness-predicts-variceal-bleeding-in-hiv-hcv-coinfected-patients-with-compensated-cirrhosis
#2
Nicolás Merchante, Antonio Rivero-Juárez, Francisco Téllez, Dolores Merino, Maria José Ríos-Villegas, Guillermo Ojeda-Burgos, Mohamed Omar, Juan Macías, Antonio Rivero, Monserrat Pérez-Pérez, Miguel Raffo, Inmaculada López-Montesinos, Manuel Márquez-Solero, Maria Amparo Gómez-Vidal, Juan A Pineda
BACKGROUND: A liver stiffness (LS) < 21 kPa has a high negative predictive value (NPV) to exclude the presence of esophageal varices (EV) at risk of bleeding in HIV/HCV-coinfected patients. Consequently, upper gastrointestinal endoscopy (UGE) for the screening of EV could be avoided in these patients. However, this strategy has not been widely accepted due to concerns about its safety. OBJECTIVE: To assess the ability of LS to predict the risk of portal hypertensive gastrointestinal bleeding (PHGB) in HIV/HCV-coinfected patients with compensated cirrhosis...
December 5, 2016: AIDS
https://www.readbyqxmd.com/read/27921053/metastatic-esophageal-cancer-presenting-as-an-orbital-mass
#3
Sunil Pokharel, Ghassan Kabbach, Seth J Richter, Laura Chiu
We report a case of adenocarcinoma of the esophagus presenting as an orbital metastasis prior to the primary diagnosis. A 66-year-old white male presented to his ophthalmologist with right orbital swelling for several months. Magnetic resonance imaging revealed a supraorbital infiltrative mass. Pathology from the mass revealed findings consistent with adenocarcinoma of gastrointestinal origin. Upper endoscopy revealed distal esophageal stricture and irregularities. Pathology from the esophagus showed the same malignancy found in the orbit...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27920706/ipilimumab-induced-enteritis-without-colitis-a-new-challenge
#4
Marcus Messmer, Sunita Upreti, Yaman Tarabishy, Nikhilesh Mazumder, Reezwana Chowdhury, Mark Yarchoan, Matthias Holdhoff
INTRODUCTION: Ipilimumab is an immune checkpoint inhibitor targeting cytotoxic T-lymphocyte associated antigen 4 (CTLA4), approved to treat metastatic melanoma. It was the first therapy shown to prolong survival in a large, randomized clinical trial. However, immune-related adverse events are common and can be severe. Enterocolitis is a common adverse event with ipilimumab, but enteritis without colitis has not been previously described. CASE REPORT: An 83-year-old man presented to our hospital with grade 3 diarrhea for 5 days...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27920702/esophageal-cancer-with-bone-marrow-hyperplasia-mimicking-bone-metastasis-report-of-a-case
#5
Hiromi Yasuda, Tadanobu Shimura, Masato Okigami, Shigeyuki Yoshiyama, Masaki Ohi, Koji Tanaka, Yasuhiko Mohri, Masato Kusunoki
A 63-year-old man visited the clinic with numbness in the right hand. Magnetic resonance imaging demonstrated multiple low-intensity lesions in the cervical vertebrae and sacrum, which was suspicious of cervical bone metastasis. Fluorodeoxyglucose positron emission tomography/computed tomography revealed areas of increased fluorodeoxyglucose uptake in the thoracic esophagus, sternum and sacrum. A flat, elevated esophageal cancer was identified by upper gastrointestinal endoscopy, and the macroscopic appearance indicated early-stage disease...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27920700/primary-ewing-sarcoma-primitive-neuroectodermal-tumor-of-the-stomach
#6
Safi Khuri, Hayim Gilshtein, Sa'd Sayidaa, Bishara Bishara, Yoram Kluger
Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) is a tumor of small round cells arising in skeletal tissues. These tumors rarely arise in the stomach. We present a 31-year-old healthy female patient who was admitted to our surgical ward due to upper gastrointestinal hemorrhage. Upper endoscopy revealed a large ulcerated bleeding mass originating from the lesser curvature. Biopsy revealed tumor cell immunoreactivity positive for CD99, vimentin, and Ki67 (an index of proliferation). These findings were compatible with gastric ES/PNET...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27920661/endoscopic-removal-of-a-duodenal-perforating-leg-of-glasses-with-dormia-basket
#7
Li Wang, Wei Wen, Jiamiao Huang, Weijie Hu, Renrong Zhou, Xin Li, Xiaojiang Wang
Ingestion of foreign bodies is common in clinical practice. Most ingested foreign bodies will pass through the gastrointestinal (GI) tract without any problems. While GI tract injury due to the ingested foreign body such as a toothpick, a fishbone, a date pit, or a chicken bone, is common, duodenal perforation is rare. In this report, our experience with this rare entity is shared. We present a 38-year-old male patient with GI tract perforation in the bulbus of the duodenum due to a leg of glasses. The patient was admitted to our hospital with severe abdominal pain...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27916772/slow-progression-of-gastric-adenocarcinoma-of-fundic-gland-type-a-case-report
#8
Chiaki Kusumoto, Kenji Shigehara, Susumu Take, Kuniharu Ishiki, Kouhei Taniguchi
Here we report the case of a 73-year-old male who had undergone esophagogastroduodenoscopy (EGD) at a nearby hospital or at our hospital every year since 2006. In 2013, EGD results revealed a discolored lesion, measuring 6mm in diameter, on the anterior side of the upper body in the stomach. Helicobacter pylori (HP) was eradicated in 2010, and the background mucosa around the lesion was endoscopically diagnosed as non-atrophic. We performed endoscopic biopsy of the lesion. Histological examination of the specimen confirmed gastric adenocarcinoma of the fundic gland type...
2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/27916367/esophageal-duplication-cysts-and-closure-of-the-muscle-layer
#9
Leo Andrew Benedict, Sigrid Bairdain, Jessica K Paulus, Carl-Christian Jackson, Catherine Chen, Cassandra Kelleher
BACKGROUND: Foregut duplication cysts are rare congenital anomalies that require surgical intervention with approximately 10%-15% of all gastrointestinal duplication cysts originating from the esophagus. Consensus is lacking among surgeons regarding closure of the esophageal muscle layer after resection of an esophageal duplication cyst and long-term outcomes are poorly documented. Therefore, we conducted the first study comparing complication rates in patients undergoing closure versus nonclosure of the esophageal muscle layer after esophageal duplication cyst resection...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27909874/is-daily-low-dose-aspirin-safe-to-take-following-laparoscopic-roux-en-y-gastric-bypass-for-obesity-surgery
#10
Xian Kang, Dennis Hong, Mehran Anvari, Maria Tiboni, Nalin Amin, Scott Gmora
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery is a safe and effective procedure for patients with severe obesity. One potential complication of LRYGB is the development of marginal ulcers (MUs). Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to significantly increase the likelihood of developing marginal ulcers after surgery. However, the risk associated with low-dose aspirin consumption is not well defined. We examined the impact of daily low-dose aspirin (81 mg) on the development of marginal ulcers following LRYGB...
December 1, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27904252/hemobilia
#11
REVIEW
Rakesh Navuluri
Hemobilia is a rare source of upper gastrointestinal bleeding, though the incidence is increasing along with the rise in minimally invasive biliary interventions. Prompt diagnosis and treatment rests on having appropriate clinical suspicion which should be based on the patient's presenting signs and symptoms, as well as history including recent instrumentation. Endoscopy should be reserved for cases of upper gastrointestinal bleeding with low suspicion for hemobilia. Interventional radiology may be the first-line diagnostic and therapeutic option for patients with a high suspicion of hemobilia...
December 2016: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/27898350/cronkhite-canada-syndrome-complicated-by-pulmonary-embolism-a-case-report
#12
Neha L Nemade, Urvi B Shukla, Gajanan D Wagholikar
INTRODUCTION: Cronkhite Canada Syndrome (CCS) is a rare syndrome, described in 1955 by Americans, Leonard Wolsey Cronkhite and Wilma Jeanne Canada in the New England Journal of Medicine [1]. About 450 cases have been reported. Complications, like malignant transformation, unprovoked thromboembolism is known. Since there is wide variability in medical presentation, no definitive diagnostic and treatment protocol s have been set. The mortality remains at 55%. CASE PRESENTATION: We report a case of a 50 year old male patient presenting with diarrhea, weight loss, abdominal pain, ectodermal features...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27895860/hydatid-liver-cyst-causing-portal-vein-thrombosis-and-cavernous-transformation-a-case-report-and-literature-review
#13
Serdar Kirmizi, Cuneyt Kayaalp, Sezai Yilmaz
A 33-year-old male with abdominal distention after meals was admitted to the hospital. He had a history of surgery for hydatid liver cyst. The cyst was located at the liver hilum and there were portal venous thrombosis and cavernous transformation. It had been treated with partial cystectomy, omentoplasty and albendazole. Two years later at the admission to our center, his laboratory tests were in normal ranges. Abdominal imaging methods revealed splenomegaly, portal vein thrombosis, cavernous transformation and the previously operated hydatid liver cyst...
2016: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/27894604/evaluation-of-the-efficacy-of-therapeutic-endoscopy-in-gastrointestinal-bleeding-secondary-to-angiodysplasias
#14
J Arribas Anta, C Zaera de la Fuente, R Martín Mateos, J A González Martín, A Cañete Ruiz, D Boixeda de Miquel, A Albillos Martínez
INTRODUCTION: Gastrointestinal angiodysplasias are defined as vascular dilations that communicate capillaries and veins in the walls of the digestive tract. The clinical presentation of these lesions varies from chronic occult bleeding to severe gastrointestinal hemorrhage. AIM: The primary aim of our study was to analyze lesion location, the efficacy of therapeutic endoscopy with argon plasma coagulation, and the factors associated with rebleeding in patients with gastrointestinal angiodysplasias...
November 25, 2016: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/27893668/outcome-of-endoscopy-negative-iron-deficiency-anemia-in-patients-above-65-a-longitudinal-multicenter-cohort
#15
Raphaël Clere-Jehl, Erik Sauleau, Stefan Ciuca, Mickael Schaeffer, Amanda Lopes, Bernard Goichot, Thomas Vogel, Georges Kaltenbach, Eric Bouvard, Jean-Louis Pasquali, Daniel Sereni, Emmanuel Andres, Anne Bourgarit
After the age of 65 years, iron deficiency anemia (IDA) requires the elimination of digestive neoplasia and is explored with upper and lower gastrointestinal (GI) endoscopy. However, such explorations are negative in 14% to 37% of patients. To further evaluate this issue, we evaluated the outcomes of patients aged over 65 years with endoscopy-negative IDA.We retrospectively analyzed the outcomes of in-patients over the age of 65 years with IDA (hemoglobin <12 g/dL and ferritin <70 μg/L) who had negative complete upper and lower GI endoscopies in 7 tertiary medical hospitals...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27893159/modified-technique-for-common-carotid-artery-transposition-in-standing-horses
#16
Heidi Tapio, David Argüelles, Luis A Gracia-Calvo, Marja Raekallio
OBJECTIVE: To describe a modified technique for permanent translocation of the common carotid artery (CCA) to a subcutaneous position in standing horses. STUDY DESIGN: Experimental study. ANIMALS: Healthy adult Standardbred and Warmblood horses (n = 8). METHODS: Surgery was performed with the horses standing under sedation and with local anesthesia. A combination of previously described techniques was used modifying the approach and closure of the incision...
November 28, 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27890681/continent-anal-urinary-diversion-in-classic-bladder-exstrophy-45-year-experience
#17
Peter Rubenwolf, Christian Hampel, Frederik Roos, Raimund Stein, Sebastian Frees, Joachim W Thüroff, Christian Thomas
OBJECTIVE: To evaluate the long-term outcomes in patients with classic bladder exstrophy (CBE) and continent anal urinary diversion (CAD) for continence, upper urinary tract status, secondary malignancies and sexual function. PATIENTS AND METHODS: The medical records of 82 exstrophy patients having undergone CAD in our department between 1970 and 2015 were reviewed. Patients were invited for follow-up examinations and asked to complete validated questionnaires relating to sexual function...
November 24, 2016: Urology
https://www.readbyqxmd.com/read/27889734/retained-capsule-endoscope
#18
Jayalaxmi S Aihole, G S Vishnumurthy, M Narendra Babu
BACKGROUND: Capsule endoscopy was invented to visualize the entire small intestine in a non- invasive manner in adults. CASE CHARACTERISTICS: 1 y, 9 mo-old boy presented with generalized edema for last 3 months. His routine investigations, including the upper gastrointestinal endoscopy, colonoscopy, and contrast enhanced computed tomography scan (CECT) were normal. In view of clinical suspicion of protein losing enteropathy, we planned capsule endoscopy. OBSERVATION: The capsule was not passed even after 3 weeks...
November 15, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27889483/classification-surgical-management-and-outcomes-of-patients-with-gastrogastric-fistula-after-roux-en-y-gastric-bypass
#19
Lara Ribeiro-Parenti, Gregoire De Courville, Abdenasser Daikha, Konstantinos Arapis, Denis Chosidow, Jean-Pierre Marmuse
BACKGROUND: Gastrogastric fistula (GGF) is a known complication after Roux-en-Y gastric bypass that can lead to marginal ulceration (MU) and failure of weight loss. OBJECTIVES: To describe our experience with GGF management and propose a classification of GGF based on its anatomic location. SETTING: University hospital, France. METHODS: After internal review board approval, data from all patients with a GGF were reviewed...
September 28, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27885762/esophageal-tuberculosis-with-coexisting-opportunistic-infections-in-a-renal-allograft-transplant-recipient
#20
Sunil Kumar, Mukut Minz, Saroj K Sinha, Kim Vaiphei, Ashish Sharma, Sarbpreet Singh, Deepesh B Kenwar
We report a renal allograft transplant recipient with esophageal tuberculosis (TB) coinfected with herpes simplex virus (HSV) and Candida. The patient presented with oropharyngeal candidiasis and was started on fluconazole. Upper gastrointestinal endoscopy showed whitish patches with mucosal ulcers in the esophagus. Histopathological examination confirmed TB and HSV infection. The patient recovered after antiviral, antifungal, and anti-tubercular therapy with reduction in immunosuppression. In a TB-endemic zone, TB can coexist with opportunistic infections in an immunocompromised host...
November 25, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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