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Article ; Online: Microscopic colitis: What is it, and what are the treatment options?

Westbrook, Katherine E / Garber, Ari

2024 Volume 91, Issue 4, Page(s) 215–216

MeSH term(s)	Humans ; Colitis, Microscopic/diagnosis ; Colitis, Microscopic/drug therapy ; Diarrhea
Language	English
Publishing date	2024-04-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	639116-3
ISSN	1939-2869 ; 0891-1150
ISSN (online)	1939-2869
ISSN	0891-1150
DOI	10.3949/ccjm.91a.23057
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Article ; Online: Comparative Effectiveness of Virtual Versus In-person Visits for Abdominal Pain During the COVID-19 Pandemic.

Sasankan, Priya / McMichael, John / Lyu, Ruishen / Rouphael, Carol / Baggott, Brian / Vargo, John / Garber, Ari

Digestive diseases and sciences

2024 Volume 69, Issue 3, Page(s) 720–727

Abstract: Background and aims: The COVID-19 pandemic has highlighted the importance of telemedicine in improving healthcare access and reducing costs. This study aimed to assess order compliance in the virtual versus in-person setting for the initial evaluation ... ...

Abstract	Background and aims: The COVID-19 pandemic has highlighted the importance of telemedicine in improving healthcare access and reducing costs. This study aimed to assess order compliance in the virtual versus in-person setting for the initial evaluation of abdominal pain (AP) prior to and during the pandemic. Methods: A retrospective evaluation of virtual and in-person outpatient gastroenterology visits for AP were identified through natural language processing from January 2019 through September 2021 at the Cleveland Clinic main campus and regional hospitals in Ohio. We assessed the number and type of orders placed for patients and measured compliance through order completion. This study received Institutional Review Board approval (IRB 21-514). Results: Among 20,356 patients at their initial visit, 79% had orders placed, of which 40% had pandemic in-person visits, 13% had pandemic virtual visits, and 47% had pre-pandemic in-person visits. Patients seen virtually were 65.1% less likely to complete orders compared to patients seen in-person (p < 0.001) during the pandemic. Patients seen in a pandemic virtual setting were 71.0% less likely to complete imaging orders (p < 0.001), 82.6% less likely to complete procedure orders (p < 0.001), and 60.5% less likely to complete lab orders (p < 0.001). Conclusion: Compared with in-person visits, patients seen virtually for their first presentation of AP were less likely to complete labs, imaging, and endoscopic evaluations. In-person visits were more successful with patient order completion during the pandemic. These findings highlight that virtual visits for AP, despite convenience, may compromise care delivery and warrant additional care coordination to achieve compliance with medical recommendations.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Pandemics ; Retrospective Studies ; Abdominal Pain/diagnosis ; Abdominal Pain/epidemiology ; Abdominal Pain/etiology ; Outpatients ; Telemedicine
Language	English
Publishing date	2024-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1007/s10620-023-08236-1
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Article ; Online: Extraintestinal Manifestations of Inflammatory Bowel Disease: Epidemiology, Etiopathogenesis, and Management.

Garber, Ari / Regueiro, Miguel

Current gastroenterology reports

2019 Volume 21, Issue 7, Page(s) 31

Abstract: Purpose of review: Extraintestinal manifestations (EIMs) of inflammatory bowel disease (IBD) represent a complex array of disease processes with variable epidemiologic penetrance, genetic antecedents, and phenotypic presentations. The purpose of this ... ...

Abstract	Purpose of review: Extraintestinal manifestations (EIMs) of inflammatory bowel disease (IBD) represent a complex array of disease processes with variable epidemiologic penetrance, genetic antecedents, and phenotypic presentations. The purpose of this review is to provide an overview of primary and secondary EIMs as well as salient treatment strategies utilized. Recent findings: While the genetic antecedents remain incompletely understood, the treatment armamentarium for EIMs has expanded with new pharmaceutical drug classes that effectively treat IBD. EIMs are an increasingly recognized complication of IBD that require prompt recognition, multidisciplinary management, and a multifaceted therapeutic approach. This review highlights the complexities and ramifications of EIM management and offers therapeutic guidance.
MeSH term(s)	Eye Diseases/diagnosis ; Eye Diseases/etiology ; Eye Diseases/therapy ; Humans ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/epidemiology ; Mouth Diseases/diagnosis ; Mouth Diseases/etiology ; Mouth Diseases/therapy ; Musculoskeletal Diseases/diagnosis ; Musculoskeletal Diseases/etiology ; Musculoskeletal Diseases/therapy ; Skin Diseases/diagnosis ; Skin Diseases/etiology ; Skin Diseases/therapy
Language	English
Publishing date	2019-05-16
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2041376-2
ISSN	1534-312X ; 1522-8037
ISSN (online)	1534-312X
ISSN	1522-8037
DOI	10.1007/s11894-019-0698-1
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Article ; Online: Jejunal necrosis after internal herniation of Roux limb through Petersen defect.

Bhagya Rao, Bhavana / Garber, Ari / Achkar, Jean-Paul

Gastrointestinal endoscopy

2019 Volume 90, Issue 2, Page(s) 317–318

MeSH term(s)	Anastomosis, Roux-en-Y/adverse effects ; Female ; Hernia/etiology ; Humans ; Intestinal Diseases/etiology ; Intestine, Small ; Jejunum/pathology ; Middle Aged ; Necrosis/etiology ; Postoperative Complications/etiology ; Postoperative Complications/pathology
Language	English
Publishing date	2019-04-05
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	391583-9
ISSN	1097-6779 ; 0016-5107
ISSN (online)	1097-6779
ISSN	0016-5107
DOI	10.1016/j.gie.2019.04.198
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Article: Novel Therapeutic Strategies in the Management of Non-Variceal Upper Gastrointestinal Bleeding.

Garber, Ari / Jang, Sunguk

Clinical endoscopy

2016 Volume 49, Issue 5, Page(s) 421–424

Abstract: Non-variceal upper gastrointestinal bleeding, the most common etiology of which is peptic ulcer disease, remains a persistent challenge despite a reduction in both its incidence and mortality. Both pharmacologic and endoscopic techniques have been ... ...

Abstract	Non-variceal upper gastrointestinal bleeding, the most common etiology of which is peptic ulcer disease, remains a persistent challenge despite a reduction in both its incidence and mortality. Both pharmacologic and endoscopic techniques have been developed to achieve hemostasis, with varying degrees of success. Among the pharmacologic therapies, proton pump inhibitors remain the mainstay of treatment, as they reduce the risk of rebleeding and requirement for recurrent endoscopic evaluation. Tranexamic acid, a derivative of the amino acid lysine, is an antifibrinolytic agent whose role requires further investigation before application. Endoscopically delivered pharmacotherapy, including Hemospray (Cook Medical), EndoClot (EndoClot Plus Inc.), and Ankaferd Blood Stopper (Ankaferd Health Products), in addition to standard epinephrine, show promise in this regard, although their mechanisms of action require further investigation. Non-pharmacologic endoscopic techniques use one of the following two methods to achieve hemostasis: ablation or mechanical tamponade, which may involve using endoscopic clips, cautery, argon plasma coagulation, over-the-scope clipping devices, radiofrequency ablation, and cryotherapy. This review aimed to highlight these novel and fundamental hemostatic strategies and the research supporting their efficacy.
Language	English
Publishing date	2016-09-30
Publishing country	Korea (South)
Document type	Review ; Journal Article
ZDB-ID	2643507-X
ISSN	2234-2443 ; 2234-2400
ISSN (online)	2234-2443
ISSN	2234-2400
DOI	10.5946/ce.2016.110
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Article ; Online: Germline pathogenic variants in cancer risk genes among patients with thyroid cancer and suspected predisposition.

Kamihara, Junne / Zhou, Jing / LaDuca, Holly / Wassner, Ari J / Dalton, Emily / Garber, Judy E / Black, Mary Helen

Cancer medicine

2022 Volume 11, Issue 8, Page(s) 1745–1752

Abstract: Purpose: Multigene panels allow simultaneous testing of genes involved in cancer predisposition. Thyroid cancer (TCa) is a component tumor of several cancer predisposition syndromes, but the complete landscape of germline variants predisposing to TCa ... ...

Abstract	Purpose: Multigene panels allow simultaneous testing of genes involved in cancer predisposition. Thyroid cancer (TCa) is a component tumor of several cancer predisposition syndromes, but the complete landscape of germline variants predisposing to TCa remains to be determined. Methods: Clinical information and genetic test results were reviewed from over 170,000 individuals who had multigene panel testing for hereditary cancer at a single diagnostic laboratory. Germline pathogenic and likely pathogenic variants ("pathogenic variants") were examined among individuals with TCa. A cohort with breast cancer (BCa) was examined to serve as a comparison group and to determine the added contribution of TCa to the ascertainment of genetic risk. Results: Of 3134 individuals with TCa, 291 (9.3%) were found to have one or more pathogenic variant(s). Among 904 individuals with TCa alone, 7.5% had one or more pathogenic variant(s), similar to those with BCa alone (8.4%). In all groups, CHEK2 was the gene with the highest number of pathogenic variants identified, with a significantly increased frequency among individuals with a history of both thyroid and BCa compared to BCa alone. Conclusions: A high prevalence of germline pathogenic variants was observed among individuals with TCa referred for hereditary cancer genetic testing, even in the absence of other cancer diagnoses. These data suggest that TCa may be an under-recognized component of cancer predisposition syndromes.
MeSH term(s)	Genetic Predisposition to Disease ; Genetic Testing/methods ; Germ Cells ; Germ-Line Mutation ; Humans ; Syndrome ; Thyroid Neoplasms/epidemiology ; Thyroid Neoplasms/genetics
Language	English
Publishing date	2022-02-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2659751-2
ISSN	2045-7634 ; 2045-7634
ISSN (online)	2045-7634
ISSN	2045-7634
DOI	10.1002/cam4.4549
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Article: Mechanisms and Management of Acute Pancreatitis.

Garber, Ari / Frakes, Catherine / Arora, Zubin / Chahal, Prabhleen

Gastroenterology research and practice

2018 Volume 2018, Page(s) 6218798

Abstract: Acute pancreatitis represents a disorder characterized by acute necroinflammatory changes of the pancreas and is histologically characterized by acinar cell destruction. Diagnosed clinically with the Revised Atlanta Criteria, and with alcohol and ... ...

Abstract	Acute pancreatitis represents a disorder characterized by acute necroinflammatory changes of the pancreas and is histologically characterized by acinar cell destruction. Diagnosed clinically with the Revised Atlanta Criteria, and with alcohol and cholelithiasis/choledocholithiasis as the two most prominent antecedents, acute pancreatitis ranks first amongst gastrointestinal diagnoses requiring admission and 21st amongst all diagnoses requiring hospitalization with estimated costs approximating 2.6 billion dollars annually. Complications arising from acute pancreatitis follow a progression from pancreatic/peripancreatic fluid collections to pseudocysts and from pancreatic/peripancreatic necrosis to walled-off necrosis that typically occur over the course of a 4-week interval. Treatment relies heavily on fluid resuscitation and nutrition with advanced endoscopic techniques and cholecystectomy utilized in the setting of gallstone pancreatitis. When necessity dictates a drainage procedure (persistent abdominal pain, gastric or duodenal outlet obstruction, biliary obstruction, and infection), an endoscopic ultrasound with advanced endoscopic techniques and technology rather than surgical intervention is increasingly being utilized to manage symptomatic pseudocysts and walled-off pancreatic necrosis by performing a cystogastrostomy.
Language	English
Publishing date	2018-03-15
Publishing country	Egypt
Document type	Journal Article ; Review
ZDB-ID	2435460-0
ISSN	1687-630X ; 1687-6121
ISSN (online)	1687-630X
ISSN	1687-6121
DOI	10.1155/2018/6218798
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Article ; Online: Novel Therapeutic Strategies in the Management of Non-Variceal Upper Gastrointestinal Bleeding

Ari Garber / Sunguk Jang

Clinical Endoscopy, Vol 49, Iss 5, Pp 421-

2016 Volume 424

Abstract	Non-variceal upper gastrointestinal bleeding, the most common etiology of which is peptic ulcer disease, remains a persistent challenge despite a reduction in both its incidence and mortality. Both pharmacologic and endoscopic techniques have been developed to achieve hemostasis, with varying degrees of success. Among the pharmacologic therapies, proton pump inhibitors remain the mainstay of treatment, as they reduce the risk of rebleeding and requirement for recurrent endoscopic evaluation. Tranexamic acid, a derivative of the amino acid lysine, is an antifibrinolytic agent whose role requires further investigation before application. Endoscopically delivered pharmacotherapy, including Hemospray (Cook Medical), EndoClot (EndoClot Plus Inc.), and Ankaferd Blood Stopper (Ankaferd Health Products), in addition to standard epinephrine, show promise in this regard, although their mechanisms of action require further investigation. Non-pharmacologic endoscopic techniques use one of the following two methods to achieve hemostasis: ablation or mechanical tamponade, which may involve using endoscopic clips, cautery, argon plasma coagulation, over-the-scope clipping devices, radiofrequency ablation, and cryotherapy. This review aimed to highlight these novel and fundamental hemostatic strategies and the research supporting their efficacy.
Keywords	Endoscopy ; Hemostasis ; Peptic ulcer ; Embolization ; therapeutic ; Gastrointestinal hemorrhage ; Internal medicine ; RC31-1245 ; Diseases of the digestive system. Gastroenterology ; RC799-869
Language	English
Publishing date	2016-09-01T00:00:00Z
Publisher	Korean Society of Gastrointestinal Endoscopy
Document type	Article ; Online
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Article ; Online: Correction to: Comparative Effectiveness of Commercial Bowel Preparations in Ambulatory Patients Presenting for Screening or Surveillance Colonoscopy.

Sarvepalli, Shashank / Garber, Ari / Burke, Carol A / Gupta, Niyati / Ibrahim, Mounir / McMichael, John / Morris-Stif, Gareth / Bhatt, Amit / Vargo, John / Rizk, Maged / Rothberg, Michael B

Digestive diseases and sciences

2022 Volume 67, Issue 4, Page(s) 1426

Language	English
Publishing date	2022-03-04
Publishing country	United States
Document type	Published Erratum
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1007/s10620-022-07456-1
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Article ; Online: Video Consent for Colonoscopy Improves Knowledge Retention and Patient Satisfaction: A Randomized Controlled Study.

Padival, Ruthvik / Harris, Kevin B / Garber, Ari / El-Khider, Faris / Kichler, Adam / Vargo, John / Baggott, Brian B

Journal of clinical gastroenterology

2021 Volume 56, Issue 5, Page(s) 433–437

Abstract: Background and aim: Informed consent for endoscopy is variable across institutions and remains understudied in gastrointestinal endoscopy. This study aims to standardize informed consent for screening and diagnostic colonoscopies with a supplemental ... ...

Abstract	Background and aim: Informed consent for endoscopy is variable across institutions and remains understudied in gastrointestinal endoscopy. This study aims to standardize informed consent for screening and diagnostic colonoscopies with a supplemental video tool that includes the key components of informed consent. Methods: A video tool was developed that incorporated the key components of informed consent for colonoscopy. In addition, a 7-question survey was developed to query patients on core aspects of informed consent and satisfaction with the informed consent process. Patients undergoing elective outpatient colonoscopy with conscious sedation were randomized to traditional consent or consent with the addition of a video tool. A pilot study determined the sample size. Traditional consent was standard of practice before the procedure. Patients in the video tool group watched the video tool in the preprocedure area followed by traditional consent. Both groups had the opportunity to address questions with the attending physician before the procedure. All patients were contacted 1 to 2 days following the colonoscopy to answer the question survey. Results: A total of 110 patients were eligible for participation, and 91 were included in the final data analysis. Subjects in the video tool group demonstrated significantly higher recall of key aspects of informed consent and higher satisfaction with the informed consent process versus the traditional consent group. The history of prior colonoscopy was similar between both groups. Mean endoscopy operation metrics were not negatively impacted by the inclusion of the video tool. Conclusion: Patients undergoing screening and diagnostic colonoscopies who received informed consent supplemented by a video tool had a higher recall of core aspects of informed consent and higher satisfaction with the process, with no impact on procedural times.
MeSH term(s)	Colonoscopy ; Humans ; Informed Consent ; Patient Satisfaction ; Pilot Projects ; Surveys and Questionnaires
Language	English
Publishing date	2021-07-28
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	448460-5
ISSN	1539-2031 ; 0192-0790
ISSN (online)	1539-2031
ISSN	0192-0790
DOI	10.1097/MCG.0000000000001589
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