April 2013 Vol XXXVII Issue 4

Previous MonthNext Month

Frontiers in Endoscopy, Series #2

Difficult Bile Duct Stones: A Review of Current Endoscopic Treatments

Patrick J. Laing, Douglas G. Adler

Difficult stones are more than just large stones. Altered biliary anatomy, common bile duct (CBD) stone angulation and CBD to stone diameter ratio are factors that make stones more difficult to remove. This review will describe the endoscopic therapeutic options that are currently used for the treatment of difficult CBD stones, with a focus on success rates and complication rates.

Nutrition Issues in Gastroenterology, Series #116

Nephrolithiasis and Gastrointestinal Tract Diseases: Can Diet Intervention Help?

Antonio Nouvenne, Andrea Ticinesi, Tiziana Meschi

The interconnections between diet, nephrolithiasis and gastrointestinal disease are complex. Here we discuss epidemiologic and physiopathologic aspects of intestinal disease-associated nephrolithiasis and the role of diet in contrasting onset and relapses of kidney stones.

Nutrition Issues in Gastroenterology, Pancreatic Enzyme Table

Pancreatic Enzyme Table

Stacey McCray, RD

FDA-Approved Pancreatic Enzyme Replacement Therapy

A Special Article

Elective Upper Gastrointestinal Endoscopy in an Outpatient Endoscopy Center: Impact on Patient Management

Tabassum Waheed, Alfred L. Hurwitz

Here we present a study evaluating the records of 100 consecutive patients coming to an ambulatory endoscopy center for outpatient esophagogastroduodenoscopy (EGD). The purpose was to determine whether or not elective outpatient EGD influenced patient management outcomes. Older age (>60 years) plays a significant predictive role as does recent NSAID/ASA use. These may be important factors in predicting those whose treatment will change after EGD.

A Case Report

A Rare and Fatal Case of Nasogastric Tube Intubation Causing Gastric Perforation

Steven Guttmann, Robert Aaron, Rabin Rahmani , Ira Mayer

Departments Section

From the Pediatric Gastroenterology Literature

Ulcerative Colitis in Australia: Is IBD in Children Increasing?

Previous studies have suggested that inflammatory bowel disease (IBD) incidence is increasing worldwide, and in particular, the incidence of ulcerative colitis (UC) in Victoria, Australia is one of the highest in the world. The authors of this study evaluated the incidence of pediatricUC from 1950 to 2009.

Functional Abdominal Pain and Behavioral Therapy

Functional abdominal pain (FAP) is a common cause of referral to pediatric gastroenterologists, and treatment for this disorder is limited. The authors of this study evaluated the effectiveness of social learning and cognitive behavioral therapy (SLCBT) one year after intervention for FAP treatment. These same authors have published prior data showing improvement of FAP symptoms 6 months after SLCBT intervention.

From the Literature

Antibiotic Treatment in Patients in Septic Shock with Cirrhosis

A nested cohort study within a large retrospective database of septic shock from 28 medical centers in Canada, the United States and Saudi Arabia was carried out by the Cooperative Antimicrobial Therapy of Septic Shock Database Research Group between 1996 and 2008. The impact of initial empiric antimicrobial therapy was examined.

One Year Mortality in Patients with Hypoxic Hepatitis and Jaundice

This study was aimed to evaluate the incidence and clinical effect of jaundice in critically ill patients with hypoxic hepatitis (HH). A total of 206 consecutive patients with same were screened for the development of jaundice during the course of HH. Individuals with preexisting jaundice or liver cirrhosis at the time of admission (N=31), were excluded from analysis. Jaundice was diagnosed in patients with plasma total bilirubin levels greater than 3 mg/dL.

Adequacy of Colon Polyp Resection

To determine the rate of incompletely resected neoplastic polyps in clinical practice, a prospective study on 1427 patients who underwent colonoscopy at two medical centers and had at least one nonpedunculated polyp (5 to 20 mm), was carried out. After polyp removal was considered complete macroscopically, biopsies were obtained from the resection margin. The main outcome was a percentage of incompletely resected neoplastic polyps (incomplete resection rate ? IRR) determined by the presence of neoplastic tissue in post polypectomy biopsies.

Congenital Hepatic Fibrosis in Autosomal Recessive Polycystic Kidney Disease

To describe congenital hepatic fibrosis in patients with autosomal recessive polycystic kidney disease (ARPKD), confirmed by detection of mutations in PKHD1, patients with a combination were evaluated at NIH from 2003 to 2009, analyzing clinical, molecular, and imaging data from 73 patients (age 1 to 56 years), with kidney and liver involvement.

Tenofovir in Chronic Hepatitis B in Adolescents

To evaluate the safety and efficacy of tenofovir DF in adolescents with chronic hepatitis B (CHB), a double-blind, placebo-controlled trial was carried out on adolescents 12 to less than 18 years of age. It was randomized to 52 patients with 54 patients receiving placebo once daily for 72 weeks. The primary endpoint was virologic response (HBV DNA less than 400 copies per ml at week 72). A total of 106 patients were enrolled, 101 patients completed 72 weeks of treatment.

Medical Bulletin Board


BEVERLY HILLS, CA. March, 2013 ? In honor of Colorectal Cancer Awareness Month, fourteen doctors and nurses from La Peer Health Systems underwent colonoscopies as part of Scopefest, an event designed to boost awareness about colon cancer and lessen anxiety surrounding the screening process.

SAGES Shares Patient Information Guidelines as Part of National Colorectal Cancer Awareness Month

LOS ANGELES, CA. March, 2013 ? Colon and rectal cancer together comprise the nation?s second-leading cause of cancer deaths. Every year, about 140,000 Americans are diagnosed with colon or rectal cancer and more than 50,000 people die from it. Fortunately, the death rate from this disease has steadily been decreasing for the last 20 years due to preventative screening and more sophisticated surgical approaches


SUNNYVALE, CA, April 12, 2013 ? Avantis Medical Systems, Inc., manufacturer of the Third Eye Retroscope, is again participating in Digestive Disease Week (DDW), which will be held May 18-21, 2013 in Orlando, FL.

This year’s focus will be on the extensive clinical data showing that use of the Third Eye Retroscope can substantially enhance the quality of colonoscopy by improving the ability to view areas behind folds in the wall of the colon.