Gastrointestinal Tuberculosis Presenting as a Massive Lower Gastrointestinal Bleed in a Patient With Newly Diagnosed HIV/AIDS.

Gastrointestinal tuberculosis (GI TB) is an uncommon sequela of extrapulmonary TB, occurring in 1%-3% of TB cases worldwide. In the United States, many cases are seen in migrant populations or in immunocompromised individuals. The classic presentation of GI TB is nonspecific abdominal pain, and is not typically associated with significant, life-threatening bleeding.

De novo Hepatitis B Virus Infection in a Post-transplant Patient Causing Stage 4 Cirrhosis Necessitating Retransplant.

Hepatitis B virus (HBV) is a common cause of liver cirrhosis worldwide, almost always as a result of HBV infection at birth or a very young age. HBV very rarely causes cirrhosis when contracted as an adult. Notably, the risk of HBV progression to cirrhosis is higher in immunocompromised patients, such as liver transplant patients, although it is still quite rare.

Safe Use of POEM in a Patient With Decompensated Cirrhosis and Severe Achalasia.

Patients with both achalasia and decompensated cirrhosis can often present a therapeutic challenge because portal hypertension has generally been considered a contraindication to definitive therapies for achalasia. This case report depicts a patient who presented with progressive dysphagia, weight loss, and large-volume ascites; was diagnosed with type II achalasia and decompensated cirrhosis without esophageal varices; and underwent peroral endoscopic myotomy after preprocedural transjugular intrahepatic portosystemic shunt placement. Our case highlights the importance of multidisciplinary care and need for definitive therapies for these complex patients at high risk of malnutrition and sarcopenia.

Comprehensive Review of Cardiovascular Disease Risk in Nonalcoholic Fatty Liver Disease.

Nonalcoholic Fatty Liver Disease (NAFLD) is a growing global phenomenon, and its damaging effects in terms of cardiovascular disease (CVD) risk are becoming more apparent. NAFLD is estimated to affect around one quarter of the world population and is often comorbid with other metabolic disorders including diabetes mellitus, hypertension, coronary artery disease, and metabolic syndrome. In this review, we examine the current evidence describing the many ways that NAFLD itself increases CVD risk.

Decision aids and shared decision making in urogynecology.

Objectives: To examine the efficacy and acceptability of decision aids (DAs) in counseling urogynecology patients with prolapse, stress urinary incontinence, or refractory overactive bladder.

Methods: This pilot study enrolled 33 patients into a control group that underwent usual care without a DA, followed by 33 patients into an intervention group where providers utilized a DA for counseling. Postvisit patient surveys assessed differences in treatment preference, knowledge, and in patient-physician collaboration using SURE, CollaboRATE, and Shared Decision Making (SDM) Process scales.