Endoscopic full-thickness resection of a duodenal gastrointestinal stromal tumor.

Background And Aim: There is limited literature regarding endoscopic removal of gastrointestinal stromal tumors (GISTs) located in the duodenum. We present successful endoscopic submucosal dissection and exposed full-thickness resection (FTR) of an incidentally discovered duodenal GIST in an asymptomatic 65-year-old man.

Methods: The lesion was 1.

Outcomes of EUS-guided liver biopsy using 22-gauge versus 19-gauge needles with a novel hydrostatic sampling technique.

Background And Aims: Prior data have shown that specimen quality deteriorates when 22-gauge needles are used in place of 19-gauge needles during EUS-guided liver biopsy (EUS-LB). Emerging data suggest that a novel hydrostatic sampling technique (HST) may offer improved performance over wet suction (WS). We hypothesized that EUS-LB using a 22-gauge fine-needle biopsy needle with the HST would attain tissue adequacy similar to that of 19-gauge needles.

Management and Outcomes of Clostridioides difficile Infection in Patients on Immune Checkpoint Inhibitors.

Background: Data on the severity, management, and outcomes of Clostridioides difficile infection (CDI) in patients presenting with diarrhea while receiving immune checkpoint inhibitors (ICIs) are limited. This study aimed to evaluate the course of CDI in this population and the overlapping diagnosis of immune-related enterocolitis (irEC).

Methods: This retrospective cohort included ICI-treated patients who presented with diarrhea and underwent CDI stool nucleic acid amplification PCR testing at Memorial Sloan Kettering Cancer Center between July 2015 and July 2021.

GI Genius increases small and right-sided adenoma and sessile serrated lesion detection rate when used with EndoCuff in a real-world setting: a retrospective United States study.

Background/aims: The real-world efficacy of computer-aided detection (CADe) systems, such as GI Genius (Medtronic), is unclear. We examined the colonoscopy metrics using CADe alone and with a mucosal exposure device (EndoCuff; Olympus) in a real-world setting.

Methods: We retrospectively reviewed screening and surveillance colonoscopies before, during, and after CADe use in a large tertiary care center.

Differences in Ancestry and Presence of Gastric Precursor Lesions in Individuals With Young- and Average-Onset Gastric Cancer.

Background: There has been a paradoxical rise in young-onset gastric cancer (YOGC), defined as gastric cancer (GC) diagnosed before age 50. Precursor lesions may contribute to pathogenesis, though their role in progression to different histologic subtypes is unclear. The impact of self-reported race is also poorly characterized and may be unreliable as a proxy for genetic differences.

Open-capsule budesonide for the treatment of immune-related enteritis from checkpoint inhibitors.

Background: Limited data exist for management strategies targeting immunotherapy-related enteritis (irEnteritis). Systemic corticosteroids are commonly used but often are limited by adverse events. Enteric corticosteroids such as budesonide offer an attractive alternative; however, the ileocolonic release of enteric-coated budesonide has limited utility for diffuse enteritis.

Heat shock protein 72 supports extracellular matrix production in metastatic mammary tumors.

This study identified tumorigenic processes most dependent on murine heat shock protein 72 (HSP72) in the mouse mammary tumor virus-PyMT mammary tumor model, which give rise to spontaneous mammary tumors that exhibit HSP72-dependent metastasis to the lung. RNA-seq expression profiling of Hspa1a/Hspa1b (Hsp72) WT and Hsp72 primary mammary tumors discovered significantly lower expression of genes encoding components of the extracellular matrix (ECM) in Hsp72 knockout mammary tumors compared to WT controls. In vitro studies found that genetic or chemical inhibition of HSP72 activity in cultured collagen-expressing human or murine cells also reduces mRNA and protein levels of COL1A1 and several other ECM-encoding genes.

Non-invasive markers of inflammation in alcohol-associated liver disease: A scoping review.

Clinical manifestations of liver inflammation in alcohol-associated liver disease (ALD) can range from asymptomatic to severe alcoholic hepatitis. While biopsy is the gold standard for identifying liver inflammation, it is an invasive procedure with risks of bleeding, visceral damage, and infection. We aim to establish the state of the current literature on non-invasive markers of inflammation in ALD.

Outcomes of Endoscopic Ultrasound-guided Fine Needle Biopsy Using a Novel Hydrostatic Stylet Tissue Acquisition Technique.

Background: Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) is frequently used to obtain core samples of solid lesions. Here, we describe and evaluate a novel hydrostatic stylet (HS) technique designed to optimize core sample acquisition, reporting diagnostic yield, efficacy, and safety relative to the conventional stylet slow-pull (SP) technique.

Methods: A novel HS technique was developed and validated retrospectively.

Preferred techniques for endoscopic ultrasound-guided gastroenterostomy: a survey of expert endosonographers.

Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is an emerging procedure that lacks technical standardization with limited adoption beyond expert centers. We surveyed high-volume endosonographers about the technical aspects of EUS-GE to describe how the procedure is currently performed at expert centers and identify targets for standardization. Invitations to complete an electronic survey were distributed to 21 expert EUS practitioners at 19 U.

Impact of infection status on outcomes among patients with advanced gastric cancer treated with immune checkpoint inhibitors.

Background: Gut microbiota composition can influence cancer immunotherapy response. Recent evidence suggests infection may reduce immune checkpoint inhibitor (ICI) efficacy in lung cancer and melanoma, but thorough characterization of this association in patients with gastric cancer is lacking. We aimed to determine the impact of on survival in this population.

Prevalence of Enteric Infections in Patients on Immune Checkpoint Inhibitors and Impact on Management and Outcomes.

Background: Stool pathogen testing is recommended as part of the initial evaluation for patients with new-onset diarrhea on immune checkpoint inhibitors (ICIs), yet its significance has not been well-studied. We aimed to determine the impact of multiplex gastrointestinal (GI) pathogen PCR testing on the clinical course and use of immunosuppressive therapy in patients who develop diarrhea on ICIs.

Methods: This retrospective cohort included individuals who underwent GI pathogen panel PCR for diarrhea on ICIs at Memorial Sloan Kettering between 7/2015 and 7/2021.

Acute worsening of gastric outlet obstruction following EUS-guided gastrojejunal bypass.

Video 1Presentation and treatment of an unusual acute worsening of gastric outlet obstruction following EUS-guided gastrojejunal bypass.

Factors associated with detection of hereditary diffuse gastric cancer on endoscopy in individuals with germline CDH1 mutations.

Background And Aims: Individuals with germline pathogenic CDH1 variants have a high risk of hereditary diffuse gastric cancer. The sensitivity of EGD in detecting signet ring cell carcinoma (SRCC) in this population is low. We aimed to identify endoscopic findings and biopsy practices associated with detection of SRCC.

EUS-guided liver biopsy using a novel hydrostatic stylet technique.

Video 1Hydrostatic stylet technique for the performance of EUS-guided liver biopsy.

Pent-up demand for total shoulder arthroplasty prior to Medicare eligibility at age 65 years: evidence from a national patient database and national survey data.

Background: Rising utilization rates of total shoulder arthroplasty (TSA) paired with an aging US population herald increased future economic burden. Previous research has demonstrated evidence of "pent-up demand" in health care (delaying medical care until financially able) accompanying insurance status changes. The purpose of this study was to determine pent-up demand for TSA in the years leading up to Medicare coverage at age 65 years while identifying key drivers underlying this trend, including socioeconomic status.