December 2018 Vol XLII Issue 12

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NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #182

Revisiting Vitamin B12 Deficiency: A Clinician's Guide For the 21st Century

Brian J. Wentworth, Andrew P. Copland

Vitamin B12 (cobalamin) deficiency is a common disorder encountered across various medical and surgical disciplines. Traditional diagnosis has relied on serum cobalamin quantification; however, accumulating evidence suggests that a significant proportion of cases are missed without additional workup. This review discusses the various etiologies of B12 deficiency, provides a practical approach to diagnosis, and summarizes the available nutritional and medical literature regarding management.



LIVER DISORDERS, SERIES #10

Alcoholic Hepatitis: A Review

Navroop Nagra, Robert Hu, Gaurav Singhvi

Alcoholic Hepatitis (AH) is an acute clinical entity characterized by jaundice and coagulopathy occurring in individuals with a history of heavy alcohol use. It is associated with a high mortality rate, as treatment options available to date have been underwhelming. In this review we discuss AH with an emphasis on potential future treatment options.



INFLAMMATORY BOWEL DISEASE: A PRACTICAL APPROACH, SERIES #105

Vaccinations for Patients with Inflammatory Bowel Disease: An Updated Review

Manisha Apte, Jason Reich, Francis A. Farraye

Patients with Inflammatory Bowel Disease (IBD) are at an increased risk for infectious complications due to the immune disturbance inherent with disease pathophysiology and immunosuppressive therapies. This review highlights vaccinations for patients with IBD, suggestions for increasing vaccination rates in your practice and new changes in practice guidelines.



FRONTIERS IN ENDOSCOPY, SERIES #48

Hemospray for Gastrointestinal Bleeding: Technology Status Update

Babatunde Olaiya, Douglas G. Adler

A simple to use hemostatic agent such as a hemostatic powder may potentially impact the endoscopic management of gastrointestinal bleeding, especially in lesions less amenable to conventional endoscopy. This paper aims to describe the efficacy and safety of Hemospray (Cook Medical, Winston Salem NC) in the management of gastrointestinal bleeding.



A CASE REPORT

An Uncommon Complication of a Motor Vehicle Accident, Diagnosed via ERCP

David T. Chao, Victoria O'Connor, Karl K. Kwok



A CASE REPORT

Long Standing Crohn's Disease and Signet Ring Cell Carcinoma of the Ileum

David M. Schwartzberg, H. Tarik Kirat, Feza H. Remzi



Departments Section


Book Reviews

Digestive Disease Interventions, 1st Edition

Digestive Disease Interventions, 1st Edition, edited by Kapoor and Lorenz, is co-authored by a diverse group of experts in interventional radiology (IR), gastroenterology, and surgery whose aim is to provide a comprehensive review of the management and treatment of gastrointestinal disorders with an emphasis on image-guided gastrointestinal interventions.



From the Literature

Pattern of Alcoholic Consumption and Liver Fibrosis

To determine whether quantity, binge pattern consumption or type of alcohol was associated with liver fibrosis in patients with NAFLD, previous and current alcohol consumption was assessed in NAFLD patients undergoing liver biopsy. All subjects currently consumed less than 210 grams per week (male), or less than 140 grams per week (female). Binge consumption was defined as greater than 4 standard drinks (female), or greater than five standard drinks (male), in one sitting. Liver biopsies were scored according to the NASH CRN system with F3/4 fibrosis defined as advanced



BMI, Diabetes, and Cholangiocarcinoma Risk

Obesity and diabetes are associated with an increased liver cancer risk. To evaluate their relationship with intrahepatic cholangiocarcinoma (ICC), the second most common cause of liver cancer, a pooled analysis was conducted with a systemic review/meta-analysis of the literature. The liver cancer pooling project was a consortium of 13 U.S. based, prospective cohort studies with data from 1,541,143 individuals (ICC cases, N = 414). In this systematic review, 14 additional studies were identified and a meta-analysis was carried out, combining the results from LCCP with the results from the 5 prospective studies identified through September 2017.



Diverticular Hemorrhage and Anticoagulants

To analyze the incidence of and risk factors for recurrent diverticular hemorrhage and to determine whether discontinuing anticoagulation after diverticular hemorrhage is associated with ischemic stroke, a retrospective cohort study of patients enrolled in the OptumInsight Clinformatics database from 2000 to 2016 was carried out. Incidence rate for initial and recurrent diverticular hemorrhage was calculated by identifying patients who had hospitalizations with a primary discharge diagnosis consistent with diverticular hemorrhage.



Antibiotic Resistance in H. Pylori Infection

A systematic review and meta-analysis was carried out to assess the distribution of H. pylori resistance to commonly used antibiotics and to measure the association between antibiotic resistance and treatment failure.



Misoprostol and Aspirin-Induced Small Bowel Bleeding

A double-blind, randomized, placebo-controlled trial was carried out to determine whether misoprostol can heal small bowel ulcers in patients with small bowel bleeding who require continuous aspirin therapy. The study was prospective among 84 aspirin users who required continued aspirin therapy in Hong Kong and Japan.



Upper Gastrointestinal Bleeding with Oral Anticoagulants

To compare the incidence of hospitalization for upper gastrointestinal bleeding in patients using individual anticoagulants with and without PPI cotherapy and to determine variation according to underlying gastrointestinal bleeding risk, a retrospective cohort study in Medicare beneficiaries was carried out between January 1, 2011 and September 30, 2015. The agents studied included apixaban, dabigatran, rivaroxaban, or warfarin, with or without PPI cotherapy.



Medical Bulletin Board

ASPEN ANNOUNCES PUBLICATION OF THE GUIDEBOOK ON ENTERAL MEDICATION ADMINISTRATION

SILVER SPRING, MD - The American Society for Parenteral and Enteral Nutrition (ASPEN) announced the publication of the Guidebook on Enteral Medication Administration, a critical resource for healthcare providers managing patients who receive medications through their feeding tubes.



WISION AI APPLIES EXPERTISE IN MACHINELEARNING AND MATHEMATICAL MEDICINE TO IMPROVE POLYP DETECTION DURING COLONOSCOPY

Data published in Nature Biomedical Engineering demonstrate potential of novel algorithm to improve accuracy and effectiveness of diagnostic imaging



NEWS ALERT: BOSTON SCIENTIFIC LAUNCHES NEXT-GENERATION SCOPE FOR IMPROVED ERCP VISUALIZATION

Boston Scientific launched the SpyScope™ DSII Access & Delivery Catheter, an upgraded scope for cholangiopancreatoscopy, designed to be used with the SpyGlass™ DS System to offer clearer visualization, helping physicians better identify and define bile and pancreatic duct tissue. The improved device features increased resolution and better lighting to provide physicians with clearer imaging, which may result in more efficient evaluation during cholangiopancreatoscopy



Meetings Calendar

February 17-20, 2019 GUILD Conference 2019
April 5-7, 2019 Interdisciplinary Autoimmune Summit 2019
March 23-26, 2019 ASPEN 2019 Nutrition Science & Practice Conference
April 5-7, 2019 Interdisciplinary Autoimmune Summit 2019