April 2011 Vol XXXV Issue 4

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Nutritional Management of Chyle Leaks: An Update

Stacey McCray, Carol Rees Parrish

Nutrition therapy is a key component in the care of patients with chyle leaks and can range from primary treatment to adjunctive therapy. However, the best route for nutrition, the optimal mix of nutrients, and the required duration of the therapy are unclear. This article will review the options for a nutritional care plan and provide practical tips for implementing and monitoring such a plan.


Vaccination Considerations for Patients with Inflammatory Bowel Disease

Laleh Boroujerdi-Rad, Gil Y. Melmed

In general, standard vaccination guidelines should be followed in patients with inflammatory bowel disease (IBD). However, live vaccines should be avoided while patients are immunosuppressed. In this paper, we will review the knowledge gaps among healthcare providers and specific vaccine guidelines, with additional precautions for travel, household contacts and healthcare providers.


Prevalence of Colon Polyps in Asymptomatic Indians Undergoing Screening Colonoscopy in the U.S.A.

Shivani Kastuar, Shreya Narayanan, Sathya Kastuar, C.S. Pitchumoni

This pilot study is aimed at estimating the prevalence of colon polyps of different histologic types—those with malignant potential (adenomatous polyps and villous adenoma) and those without (hyperplastic) in the asymptomatic people of Indian origin above the age of fifty years.


EUS with Trucut Biopsy for Diagnosis of Perigastric Tuberculosis

Ellen Gutkin, Natalie Schwartz, Natalya Belova, Kaumudi Somnay

Here we present two cases, where we examined the utility of endoscopic ultrasound (EUS) in the diagnosis of perigastric lesions. EUS and fine needle aspiration (FNA) was initially performed in both patients, but due to inadequate tissue samples, further diagnostic testing was pursued using Trucut biopsy.


Acute Superior Mesenteric Vein Thrombosis: A Lethal Disease

Waheed Gul, Ronald J. Markert, Khurram Abbass

Here we present a case of acute superior mesenteric vein thrombosis, a lethal disease.

Departments Section

Book Reviews

Pediatric Obesity: Etiology, Pathogenesis, and Treatment

Over the past three decades, there has been an unprecedented increase in obesity among youth, accompanied by a troubling rise in weight-related health risks. A myriad of publications have attempted to measure the magnitude of the problem, explain its origins and understand its impact both for the current, as well as for future, generations. What has been lacking is a thoughtful compilation of scholarly works to assist those who are casually interested in the subject as well as those dedicated to finding safe, effective and sustainable means of preventing its spread until now.

IBD and IBS: Novel Mechanisms and Future Practice (Falk symposium 170)

This is a collection of 20 articles by different authors and represents the proceedings of a symposium sponsored by the Falk Foundation held in Glasgow, UK, September 2009. The overall theme is the relationship between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS).

Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. Ninth Edition 2010

To be charged with reviewing the predominant GI and hepatology textbook since 1973 is a daunting task. Two volumes, 2300 pages, 127 chapters, more than 200 contributing authors, and a companion review and assessment book continue to make this textbook a MUST HAVE for every practicing gastroenterologist and hepatologist.

From the Literature

Quality Indicators for Colonoscopy and the Risk of Interval Cancer

In order to evaluate the influence of quality indicators for colonoscopy and the risk of interval cancer, a multivariate, Cox Proportional Hazards Regression model was used. Data was collected from 186 endoscopists who were involved in a colonoscopy-based, colorectal cancerscreening program involving 45,026 subjects.

Nonalcoholic Fatty Liver in the Non-Obese Population

In order to evaluate epidemiologic data on NAFL, identified in developing countries, a prospective epidemiological study was carried out, comprising a 1:3 subsample of all adult inhabitants over 18 years of age of a rural administrative unit of West Bengal, India. Subjects positive for HBV and HCV and consuming any amount of alcohol were excluded.

Hepatoma in HBsAg-Negative Chronic HBV

Some patients chronically infected with HBV eventually lose HBsAg. Hepatocellular carcinoma (HCC) occurs in a few patients after loss of HBsAg. To elucidate this occurrence, a prospective, population-based cohort study was carried out in 2171 Alaskan native persons with chronic HBV infection, followed for an average of 19.6 years to determine factors associated with loss of HBsAg and risk of developing HCC thereafter.

Effects of Treatment of Microscopic Esophagitis Long-Term

To evaluate GERD-associated changes in esophageal histology with long-term treatment, detailed histologic findings from the LOTUS Study, baseline at 1 of 3 years after laparoscopic antireflux surgery (LARS), or Esomeprazole treatment in patients with chronic GERD were reported.

Medical Bulletin Board

Bottoms Up! Celebrating the First Innovation in Hemorrhoid Management in Decades

Introducing ANALPRAM™ ADVANCED KITS In response to growing frustration in the medical community over the scarcity of innovative therapies for hemorrhoids, Ferndale Laboratories has taken a giant step forward with the introduction of Analpram Advanced™ Kits.

Transenterix Introduces New SPIDER® Surgical System

Enhanced design delivers added strength, precision and ergonomics—through tiny incision the sizeof a dime

New Nationwide Survey Identifies Need for Increased Dialogue Between Gastroesophageal Reflux Disease or Frequent Heartburn Sufferers and Health Care Providers

Many survey respondents report that symptoms significantly disrupt their lives