Adenomatous Hyperplasia of Duodenal Brunner's Glands: An Extremely Uncommon Imitation of Malignant Pathology.

Adenomatous hyperplasia of duodenal Brunner's glands is a rare benign pathology of the duodenum linked to epigastric pain and dyspepsia. However, in rare cases, it can cause intestinal obstruction. Hence, endoscopic or surgical removal of Brunner's gland hyperplasia (BGH) has been suggested to prevent complications including hemorrhage, severe anemia due to persistent bleeding, intussusception, and obstruction.

Endoscopic Balloon Dilation Versus Stent Placement in the Management of Dominant Strictures in Primary Sclerosing Cholangitis: A Systematic Review and Meta-Analysis.

Background & Aims: Dominant strictures (DS) in primary sclerosing cholangitis (PSC) remain a matter of concern due to the cholestatic symptoms. Treatment options include endoscopic balloon dilation (EBD) or stent placement. The objective of our study was to compare the efficacy and safety between EBD and stent placement.

Association of NAFLD and Cardiovascular Events: A Systematic Review and Meta-analysis.

Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly recognized as a risk factor for cardiovascular disease (CVD) but the association remains unclear. This systematic review and meta-analysis aimed to quantify these associations.

Methodology: We searched multiple databases for articles reporting CVD outcomes in MAFLD and conducted meta-analysis.

Hepatic Angiosarcoma Presenting as Ascites: Case Report of a Rare yet Lethal Disease.

Introduction: Angiosarcomas, constituting less than 1% of all sarcomas, are rare soft tissue tumors originating from the endothelial cells. Hepatic angiosarcoma (HAS) is a rare and aggressive primary hepatic malignancy accounting for only 0.5%-2% of all liver tumors.

The Black Esophagus: A Rare Case Presentation.

Acute esophageal necrosis (AEN), also known as black esophagus or Gurvits syndrome, is an uncommon endoscopic finding characterized by diffuse, circumferential, black discoloration of the esophagus that terminates at the gastroesophageal junction. The incidence of AEN has been reported to be 0-0.2% in autopsy series and up to 0.

Disparities in Gender and Race Representation Among Authors of Inflammatory Bowel Disease Clinical Trials.

Background And Aims: Female physicians, particularly those from minority populations, are significantly underrepresented in research authorship in gastroenterology. This underrepresentation negatively impacts their career progression. This study analyses gender and race representation trends in published clinical trials in inflammatory bowel disease (IBD) and associated factors.

Treatment of Primary Biliary Cholangitis including Transplantation.

Ursodeoxycholic acid (UDCA) is the first-line treatment of primary biliary cholangitis (PBC). Long-term UDCA use significantly reduces progression to cirrhosis. UDCA improves liver enzymes and transplant-free survival rates.

COVID-19 Related Predisposition to Diabetic Ketoacidosis.

Background and aims Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can exacerbate hyperglycemia and can cause life-threatening diabetic ketoacidosis (DKA) in patients with diabetes mellitus (DM). The objective of this study is to compare the characteristics of diabetic COVID-19 patients with and without DKA and to determine the predictors of mortality in the setting of COVID-19 and DKA. Methods This is a retrospective single-center cohort study including patients admitted to our hospital with COVID-19 and DM from March 2020 to June 2020.

Medical Treatment Options for Ulcerative Colitis.

The landscape of management of ulcerative colitis, a type of inflammatory bowel disease, continues to change with advancement in pharmaceutical options as well as clinical treatment targets. Ulcerative colitis primarily involves the superficial layers of the large bowel, and cause active inflammation that can affect the colon from the rectum to the cecum in a relapsing and a remitting course. In this review, we provide evidence-based guidance on the selection of appropriate medical therapies based on individual patient and disease characteristics, with a focus on biologics and small molecules.

Impact of Obesity on Response to Biologic Therapies in Patients with Inflammatory Bowel Diseases.

Approximately 20-40% of patients with inflammatory bowel disease (IBD) are obese. Obesity is associated with inferior outcomes in patients with IBD, with lower rates of achieving remission, poor quality of life, and higher burden of unplanned healthcare utilization. Multiple cohort studies in patients with immune-mediated inflammatory diseases, including IBD, treated with biologic agents like tumor necrosis factor-α antagonists have suggested that obesity is associated with inferior response to biologic therapy.

Hematemesis as an Initial Presentation of Enteropathy-Associated T-Cell Lymphoma.

Enteropathy-associated T-cell lymphoma (EATL) is a tumor of intraepithelial T-lymphocytes arising in the small intestine. Based on the genetic profile, immunohistochemistry, and histology, EATL is divided into two subtypes. EATL type I occurs in individuals with celiac disease (CD) while EATL type II is a sporadic form that occurs in individuals without CD.

Recurrent Large Bowel Obstruction Caused by Necrotizing Pancreatitis: A Rare Manifestation.

Mechanical obstruction of the colon is rare with necrotizing pancreatitis but is associated with high morbidity and mortality. However, pancreatic ileus, colonic necrosis, and pancreatic colonic fistulae with necrotizing pancreatitis are well known. The anatomic proximity of the pancreas to the transverse colon becomes clinically relevant when a patient with pancreatitis demonstrates a localized ileus of the transverse colon (an old term "the colon cut-off sign"), even when the disease is mild, or lower gastrointestinal bleeding secondary to necrosis of the segment in severe acute pancreatitis.

Percutaneous Intervention for Myocardial Infarction After Noncardiac Surgery: Patient Characteristics and Outcomes.

Background: Few studies have explored percutaneous coronary intervention (PCI) in perioperative myocardial infarction (PMI), even though PMI is a major cause of mortality in patients undergoing urgent/emergent noncardiac surgery.

Objectives: This study sought to describe the angiographic characteristics and outcomes in patients presenting to the cardiac catheterization laboratory for myocardial infarction sustained after undergoing noncardiac surgery, with a detailed analysis of those undergoing PCI.

Methods: We included all patients presenting to the catheterization laboratory at our institution after PMI from 2003 to 2012, who had noncardiac surgery within the previous 7 days.

Transforming growth factor β and insulin signal changes in stromal fibroblasts of individual keratoconus patients.

Keratoconus (KC) is a complex thinning disease of the cornea that often requires transplantation. The underlying pathogenic molecular changes in this disease are poorly understood. Earlier studies reported oxidative stress, metabolic dysfunctions and accelerated death of stromal keratocytes in keratoconus (KC) patients.