{"title":"Intestinal Parasitic Infections in 2023.","authors":"Monjur Ahmed","doi":"10.14740/gr1622","DOIUrl":"https://doi.org/10.14740/gr1622","url":null,"abstract":"<p><p>Intestinal parasites include intestinal protozoa and intestinal helminths. Intestinal parasitic infections (IPIs) pose a global health problem affecting over one billion people worldwide. Although these infections are predominantly seen in the developing world, they are frequently seen in the developed countries, particularly in immunocompromised patients. Patients' clinical presentations generally include diarrhea, dysentery, abdominal pain, nausea, vomiting, nutritional deficiency, iron deficiency anemia, anal and perianal itching, and rarely intestinal obstruction. The intestinal parasites have similarities in their mode of transmission and life cycle. The stool test is the primary way of diagnosing IPIs. Treatment is given with various anti-parasitic agents. However, appropriate preventive measures are essential for successfully controlling the IPIs.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 3","pages":"127-140"},"PeriodicalIF":1.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/14/gr-16-127.PMC10284646.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9715652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robert Kwei-Nsoro, Bashar Attar, Hafeez Shaka, Pius Ojemolon, Muhammad Sana, Abdul Tawab Shaka, Naveen Baskaran, Philip Kanemo, Mohankumar Doraiswamy
{"title":"Independent Predictors and Causes of Thirty-Day Gastrointestinal Readmissions Following COVID-19-Related Hospitalizations: Analysis of the National Readmission Database.","authors":"Robert Kwei-Nsoro, Bashar Attar, Hafeez Shaka, Pius Ojemolon, Muhammad Sana, Abdul Tawab Shaka, Naveen Baskaran, Philip Kanemo, Mohankumar Doraiswamy","doi":"10.14740/gr1623","DOIUrl":"https://doi.org/10.14740/gr1623","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic led to significant mortality and morbidity in the United States. The burden of COVID-19 was not limited to the respiratory tract alone but had significant extrapulmonary manifestations. We decided to examine the causes, predictors, and outcomes of gastrointestinal (GI)-related causes of 30-day readmission following index COVID-19 hospitalization.</p><p><strong>Methods: </strong>We used the National Readmission Database (NRD) from 2020 to identify hospitalizations among adults with principal diagnosis of COVID-19. We identified GI-related hospitalizations within 30 days of index admission after excluding elective and traumatic admissions. We identified the top causes of GI-related readmission, and the outcomes of these hospitalizations. We used a multivariate Cox regression analysis to identify the independent predictors of readmission.</p><p><strong>Results: </strong>Among 1,024,492 index hospitalizations with a primary diagnosis of COVID-19 in the 2020 NRD database, 644,903 were included in the 30-day readmission study. Of these 3,276 (0.5%) were readmitted in 30 days due to primary GI causes. The top five causes of readmissions we identified in this study were GI bleeding, intestinal obstruction, acute diverticulitis, acute pancreatitis, and acute cholecystitis. Multivariate Cox regression analysis done adjusting for confounders showed that renal failure, alcohol abuse, and peptic ulcer disease were associated with increased odds of 30-day readmission from GI-related causes.</p><p><strong>Conclusions: </strong>GI manifestations of COVID-19 are not uncommon and remain an important cause of readmission. Targeted interventions addressing the modifiable predictors of readmission identified will be beneficial in reducing the burden on already limited healthcare resources.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 3","pages":"157-164"},"PeriodicalIF":1.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/5d/gr-16-157.PMC10284648.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9715653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samyak Dhruv, Shravya Ginnaram, Arhum Shah, Don C Rockey
{"title":"Takotsubo Cardiomyopathy Associated With Acute Pancreatitis.","authors":"Samyak Dhruv, Shravya Ginnaram, Arhum Shah, Don C Rockey","doi":"10.14740/gr1633","DOIUrl":"https://doi.org/10.14740/gr1633","url":null,"abstract":"<p><p>Takotsubo cardiomyopathy is classically associated with emotional stress in middle-aged women. In clinical practice, physical stressors are a more common cause of Takotsubo cardiomyopathy. Here, we present two patients who had acute pancreatitis as a physical stressor that caused Takotsubo cardiomyopathy, and an additional 13 cases identified in the literature. An important clinical feature of these cases is that because metabolic derangements are often encountered, close attention to electrolyte repletion with cardiac monitoring is indicated.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 3","pages":"195-200"},"PeriodicalIF":1.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/57/gr-16-195.PMC10284644.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9710360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dushyant Singh Dahiya, Fnu Nivedita, Abhilash Perisetti, Hemant Goyal, Sumant Inamdar, Manesh Kumar Gangwani, Muhammad Aziz, Hassam Ali, Chin-I Cheng, Madhusudhan R Sanaka, Mohammad Al-Haddad, Neil R Sharma
{"title":"Clinical Outcomes and Complications for Achalasia Patients Admitted After Per-Oral Endoscopic Myotomy.","authors":"Dushyant Singh Dahiya, Fnu Nivedita, Abhilash Perisetti, Hemant Goyal, Sumant Inamdar, Manesh Kumar Gangwani, Muhammad Aziz, Hassam Ali, Chin-I Cheng, Madhusudhan R Sanaka, Mohammad Al-Haddad, Neil R Sharma","doi":"10.14740/gr1617","DOIUrl":"https://doi.org/10.14740/gr1617","url":null,"abstract":"<p><strong>Background: </strong>Per-oral endoscopic myotomy (POEM) is a rapidly emerging minimally invasive procedure for management of achalasia. Same-day discharge after POEM is safe and feasible; however, some patients may need hospitalization. We aimed to identify characteristics and outcomes for achalasia patients requiring hospitalizations after POEM in the United States (US).</p><p><strong>Methods: </strong>The US National Inpatient Sample was utilized to identify all adult achalasia patients who were admitted after POEM from 2016 to 2019. Hospitalization characteristics and clinical outcomes were highlighted.</p><p><strong>Results: </strong>From 2016 to 2019, we found that 1,885 achalasia patients were admitted after POEM. There was an increase in the total number of hospitalizations after POEM from 380 in 2016 to 490 in 2019. The mean age increased from 54.2 years in 2016 to 59.3 years in 2019. Most POEM-related hospitalizations were for the 65 - 79 age group (31.8%), females (50.4%), and Whites (68.4%). A majority (56.2%) of the study population had a Charlson Comorbidity Index of 0. The Northeast hospital region had the highest number of POEM-related hospitalizations. Most of these patients (88.3%) were eventually discharged home. There was no inpatient mortality. The mean length of stay decreased from 4 days in 2016 to 3.2 days in 2019, while the mean total healthcare charge increased from $52,057 in 2016 to $65,109 in 2019. Esophageal perforation was the most common complication seen in 1.3% of patients.</p><p><strong>Conclusion: </strong>The number of achalasia patients needing hospitalization after POEM increased. There was no inpatient mortality conferring an excellent safety profile of this procedure.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 3","pages":"141-148"},"PeriodicalIF":1.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c1/3e/gr-16-141.PMC10284641.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9703669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pharmacological and Endoscopic Interventions for Prophylaxis of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis.","authors":"Emmanuel Palomera-Tejeda, Mihir Prakash Shah, Bashar M Attar, Hassam Shah, Bharosa Sharma, Roberto Oleas, Vikram Kotwal, Seema Gandhi, Hemant Raj Mutneja","doi":"10.14740/gr1620","DOIUrl":"https://doi.org/10.14740/gr1620","url":null,"abstract":"<p><strong>Background: </strong>Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) represents the most common serious complication after endoscopic retrograde cholangiopancreatography (ERCP). Rectal non-steroidal anti-inflammatory drugs (NSAIDs) and pancreatic duct stenting (PDS) are the prophylactic interventions with more evidence and efficacy; however, PEP still represents a significant source of morbidity, mortality, and economic burden. Chronic statin use has been proposed as a prophylactic method that could be cheap and relatively safe. However, the evidence is conflicting. We aimed to evaluate the impact of endoscopic and pharmacological interventions including chronic statin and aspirin use, on the development of PEP.</p><p><strong>Methods: </strong>A retrospective cohort study evaluated consecutive patients undergoing ERCP at John H. Stroger, Jr. Hospital of Cook County in Chicago from January 2015 to March 2018. Univariate and multivariate analyses were performed using logistic regression.</p><p><strong>Results: </strong>A total of 681 ERCPs were included in the study. Twelve (1.76%) developed PEP. Univariate, multivariate, and subgroup analyses did not show any association between chronic statin or aspirin use and PEP. PDS and rectal indomethacin were protective in patients undergoing pancreatic duct injection. Pancreatic duct injection, female sex, and younger age were associated with a higher risk. History of papillotomy was associated with lower risk only in the univariate analysis (all P values < 0.05).</p><p><strong>Conclusion: </strong>Chronic use of statins and aspirin appears to add no additional benefit to prevent ERCP pancreatitis. Rectal NSAIDs, and PDS after appropriate patient selection continue to be the main prophylactic measures. The lower incidence at our center compared with the reported data can be explained by the high rates of rectal indomethacin and PDS, the use of noninvasive diagnostic modalities for patient selection, and the expertise of the endoscopists.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 3","pages":"149-156"},"PeriodicalIF":1.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/90/gr-16-149.PMC10284647.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9710363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Retraction Notice to \"Association of Smoking and E-Cigarette in Chronic Liver Disease: An NHANES Study\".","authors":"","doi":"10.14740/gr1490r","DOIUrl":"https://doi.org/10.14740/gr1490r","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.14740/gr1490.].</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 3","pages":"201"},"PeriodicalIF":1.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/5e/gr-16-201.PMC10284643.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9715649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdelwahap Elghezewi, Mohamad Hammad, Mohammed El-Dallal, Mujtaba Mohamed, Ahmed Sherif, Wesam Frandah
{"title":"Trends in Hospitalizations of Esophageal Varices From 2011 to 2018: A United States Nationwide Study.","authors":"Abdelwahap Elghezewi, Mohamad Hammad, Mohammed El-Dallal, Mujtaba Mohamed, Ahmed Sherif, Wesam Frandah","doi":"10.14740/gr1627","DOIUrl":"https://doi.org/10.14740/gr1627","url":null,"abstract":"<p><strong>Background: </strong>Prevalence of gastroesophageal varices is around 50% of patients with cirrhosis. In compensated cirrhosis they are present in 30-40%. Progression from small to large varices occurs at rate of 10-12% annually. That percentage increases significantly in decompensated liver cirrhosis with gastroesophageal varices found in 85% of patients. Variceal hemorrhage occurs at a rate around 10-15% per year. The outcome of variceal hemorrhage depends on the severity of liver disease, size of varices, and presence of stigmata of recent bleeding (red whale sign). Six-week mortality of variceal hemorrhage ranges between 15% and 25%. Without treatment, variceal hemorrhage tends to recur in 60% of patients within 1 - 2 years. The aim of the study was to assess demographics of esophageal varices with and without bleeding, geographic distribution, comorbidities, outcomes, main payers, and cost of hospitalizations.</p><p><strong>Methods: </strong>The National Inpatient Sample (NIS) database from year 2011 to 2018 was used. Patients who had a primary diagnosis of esophageal varices with or without bleeding were identified using the International Classification of Diseases, Ninth Revision (ICD-9) codes (456.0 for esophageal varices with bleeding, and 456.1 for esophageal varices without bleeding), and International Classification of Diseases, 10th Revision (ICD-10) codes (I85.01 for esophageal varices with bleeding, and I85.00 for esophageal varices without bleeding) in the first two discharge diagnoses. The propensity score to calculate the inverse probability treatment weighting (IPTW) to adjust between the differences of the compared groups was implemented. Two groups were compared in terms of their hospitalization outcomes, including LOS, hospital charges, hospital mortality, and disposition.</p><p><strong>Results: </strong>A total of 322,761 patients were admitted with esophageal varices between 2011 and 2018, with 236,802 (73.6%) had bleeding esophageal varices and 85,959 (26.4%) had nonbleeding esophageal varices. The majority of the patients from both groups were white (66%), covered with Medicare (38% in the esophageal varices with bleeding vs. 41% in the nonbleeding group). There was a steady increase of patients admitted with nonbleeding esophageal varices. Most common comorbidities were liver diseases, alcohol abuse, uncomplicated hypertension and depression in both groups. There were no significant changes in OLS over the years in both groups, but there was a significant increase in hospital charges, especially in the patients with bleeding esophageal varices starting in 2015, and no change in mortality throughout the years. Regarding hospital disposition, there was a notable decline in rehab discharge in the bleeding esophageal varices group.</p><p><strong>Conclusions: </strong>Esophageal varices with and without bleeding have been steadily increasing since the beginning of this century. This may result in a substantial imp","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 3","pages":"171-183"},"PeriodicalIF":1.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/56/gr-16-171.PMC10284649.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9715651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Does Liver Resection Remain a Viable Option in Patients With Pyogenic Liver Abscess? A Single-Center Experience.","authors":"Aiman Obed, Mohammad Abuassi, Saqr Alsakarneh, Fouad Jaber, Mahmoud Fakhri, Fadi Abufares, Abdalla Bashir, Mahmood Syam, Anwar Jarrad, Ody Abdelhadi, Hassan Ghoz","doi":"10.14740/gr1611","DOIUrl":"https://doi.org/10.14740/gr1611","url":null,"abstract":"<p><p>Pyogenic liver abscesses (PLAs) are relatively rare but often fatal if left untreated. Antibiotic therapy combined with percutaneous procedures has replaced surgery as the cornerstone of treatment. However, open surgical drainage or liver resection may be a last resort. This study aimed to review our experience in treating PLA, with a focus on the conditions requiring partial liver resection as the last viable curative option. Medical records of patients with PLA admitted to Jordan Hospital between October 2014 through October 2020 were retrospectively reviewed. Medical and demographic data of all 43 patients admitted to our facility with a diagnosis of PLA were extracted. We reviewed these patients and extracted the cases that required surgical intervention. Four (three males and one female) of the 43 patients with PLA required surgical intervention. The underlying causes of liver abscesses were as follows: one traumatic due to shrapnel injury from an explosion, one following chemoembolization for hepatocellular carcinoma, and two patients with no apparent etiology. All patients were diagnosed with a computed tomography (CT) scan of the abdomen and pelvis with intravenous contrast. Two patients had negative cultures. All patients received broad-spectrum antibiotics, and all underwent CT- or ultrasound-guided percutaneous drainage or aspiration. All four patients required partial hepatic resection due to treatment failure or inaccessible percutaneous procedures with clinical improvement. Although antimicrobial and interventional therapy remains the primary treatment option in PLA, the surgical option with open surgical drainage or partial liver resection remains viable and curative in selected patients.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 3","pages":"184-191"},"PeriodicalIF":1.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/62/e2/gr-16-184.PMC10284645.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9715655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Azizullah Beran, Mouhand F H Mohamed, Thaer Abdelfattah, Yara Sarkis, Jonathan Montrose, Wasef Sayeh, Rami Musallam, Fouad Jaber, Khaled Elfert, Eleazar Montalvan-Sanchez, Mohammad Al-Haddad
{"title":"Lumen-Apposing Metal Stent With and Without Concurrent Double-Pigtail Plastic Stent for Pancreatic Fluid Collections: A Comparative Systematic Review and Meta-Analysis.","authors":"Azizullah Beran, Mouhand F H Mohamed, Thaer Abdelfattah, Yara Sarkis, Jonathan Montrose, Wasef Sayeh, Rami Musallam, Fouad Jaber, Khaled Elfert, Eleazar Montalvan-Sanchez, Mohammad Al-Haddad","doi":"10.14740/gr1601","DOIUrl":"https://doi.org/10.14740/gr1601","url":null,"abstract":"<p><strong>Background: </strong>Lumen-apposing metal stents (LAMSs) are often used to drain pancreatic fluid collections (PFCs). However, adverse events, such as stent obstruction, infection, or bleeding, have been reported. Concurrent double-pigtail plastic stent (DPPS) deployment has been suggested to prevent these adverse events. This meta-analysis aimed to compare the clinical outcomes of LAMS with DPPS vs. LAMS alone in the drainage of PFCs.</p><p><strong>Methods: </strong>An extensive search was conducted in the literature to include all the eligible studies that compared LAMS with DPPS vs. LAMS alone for drainage of PFCs. Pooled risk ratios (RRs) with the 95% confidence intervals (CIs) were obtained within a random-effect model. The outcomes were technical and clinical success, and overall adverse events, including stent migration and occlusion, bleeding, infection, and perforation.</p><p><strong>Results: </strong>Five studies involving 281 patients with PFCs (137 received LAMS plus DPPS vs. 144 received LAMS alone) were included. LAMS plus DPPS group was associated with comparable technical success (RR: 1.01, 95% CI: 0.97 - 1.04, P = 0.70) and clinical success (RR: 1.01, 95% CI: 0.88 - 1.17). Lower trends of overall adverse events (RR: 0.64, 95% CI: 0.32 - 1.29), stent occlusion (RR: 0.63, 95% CI: 0.27 - 1.49), infection (RR: 0.50, 95% CI: 0.15 - 1.64), and perforation (RR: 0.42, 95% CI: 0.06 - 2.78) were observed in LAMS with DPPS group compared to LAMS alone but without a statistical significance. Stent migration (RR: 1.29, 95% CI: 0.50 - 3.34) and bleeding (RR: 0.65, 95% CI: 0.25 - 1.72) were similar between the two groups.</p><p><strong>Conclusions: </strong>Deployment of DPPS across LAMS for drainage of PFCs has no significant impact on efficacy or safety outcomes. Randomized, controlled trials are necessary to confirm our study results, especially in walled-off pancreatic necrosis.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"16 2","pages":"59-67"},"PeriodicalIF":1.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/7f/gr-16-059.PMC10181339.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9829177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}