September 2010 Vol XXXIV Issue 9

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The Gallstone Story: Pathogenesis and Epidemiology

Neil Bajwa, Rajinder Bajwa, Ambrish Ghumman, R. M. Agrawal

Among biliary tract disease, gallstone disease is the leading cause for inpatient admissions for gastrointestinal problems. This paper will review the pathogenesis and epidemiology of gallstone disease, focusing on both unmodifiable and modifiable risk factors.


Biliary Diseases in HIV

Alexander Brun, C.S. Pitchumoni

Manifestations of human immunodeficiency virus infection range from acute primary infections to life threatening symptomatic diseases that result from opportunistic infections. This article concentrates on the etiology, clinical presentations, diagnoses and treatment options of AIDS cholangiopathy and acalculous cholecystitis.


The Use of Biologic Therapy in the Pregnant Patient

Uma Mahadevan

Inflammatory bowel disease affects women during their childbearing years, with the peak age of onset between 15 to 30 years of age. This article presents the best evidence to date on the use of anti-tumor necrosis factor (TNF) therapy on fertility and pregnancy in women with IBD.


Diagnosis and Management of Colorectal Neoplasia in Inflammatory Bowel Disease

Christopher Leung, Francis A. Farraye

Certain patients with inflammatory bowel disease are at increased risk for developing colorectal neoplasia. In this article we will review the epidemiology, risk factors, detection methods, surveillance and management issues of colorectal neoplasia in IBD patients.


The Art of Fistuloclysis: Nutritional Management of Enterocutaneous Fistulas

Kate Willcutts

Enterocutaneous (EC) fistulas, though relatively rare, are very challenging to manage. This case study is presented demonstrating the complexity of managing the EC fistula patient focusing on the nutritional management and the importance of a multidisciplinary approach.


Adult Onset Nesidioblastosis: A Diagnostic Dilemma

Dushyant Singh, Reetu Singh

This is the first reported case of nesidioblastosis in a dialysis patient, which makes it unique. Nesidioblastosis can often be unrecognized, and early dentification and prompt treatment plays a critical role in the management of such patients.

Departments Section

From the Pediatric Gastroenterology Literature

Use of Lactobacillus GG for Treatment of Allergic Colitis in Children

Cow's milk protein allergy (CMPA) is a relatively common gastrointestinal disease in infants and is associated with rectal bleeding and diarrhea. CMPA involves intestinal inflammation, and fecal calprotectin, a marker of intestinal inflammation, may be helpful in following the disease course of CMPA.

Association of Bacterial Enteritis and Intussusception in Children

Intussusception is a major case of bowel obstruction in young children, and it is commonly associated with viral gastroenteritis which may cause lymphoid hyperplasia of the Peyer's patches as a lead point. Bacterial enteritis has been described in case reports as a cause of intussusception in children; however, this association has not been studied in any retrospective manner.

Book Reviews

Curbside Consultation of the Pancreas: 49 Clinical Questions

Pancreatology is a rapidly expanding field of clinical science. The widespread dissemination of EUS and the emergence of new clinical entities such as autoimmune pancreatitis have changed significantly the evaluation and treatment of many of pancreatic disorders over the past several years.

From the Literature

Famotidine Vs. Pantoprazole in Aspirin-Related Gastropathy

To compare the efficacy/erosions in preventing recurrent symptomatic ulcers/erosions, a randomized, double-blind, control trial of 160 patients with aspirinrelated peptic ulcer/erosions, with or without a history of bleeding was performed.

Clopidogrel and PPIs

To examine the association between concurrent use of PPIs and Clopidogrel, and the risk for hospitalization for gastroduodenal bleeding and serious cardiovascular disease, a retrospective cohort study was carried out, using automated data to identify patients who received Clopidogrel between 1999 to 2005, after hospitalization for coronary heart disease.

Medical Bulletin Board

Preventing Diverticular Disease

Diverticulosis is an extremely common condition that affects the colon. Yet it is often overlooked because it produces few if any symptoms. When diverticulosis becomes diverticulitis, though, blissful ignorance gives way to pain or bleeding. You can avoid these problems by taking several simple steps, reports the August 2010 issue of Harvard Men's Health Watch.

Study in Health Affairs Confirms Quality, Safety of Nurse Anesthetist Care

There are no differences in patient outcomes when anesthesia services are provided by Certified Registered Nurse Anesthetists (CRNAs), physician anesthesiologists, or CRNAs supervised by physicians, according to the results of a new national study conducted by RTI International.

New Olympus V-System Expands Options for ERCP

Olympus America Inc., a precision technology leader designing and delivering innovative solutions in medical and surgical products among other core business areas, today launched its new V-System. The new VSystem combines Olympus' latest duodenoscope, the TJF-Q180V, with its unique V-System devices for the endoscopic retrograde cholangiopancreatography (ERCP) procedure.