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Article: Herpes Simplex Virus Esophagitis in an Immunocompetent Patient.

Shah, Raj / Patel, Stuti / Henriquez, Richard / Parikh, Jignesh / Mandalia, Amar

2023 Volume 15, Issue 9, Page(s) e44668

Abstract: Esophagitis due to herpes simplex virus (HSV) infection is a rare entity in the immunocompetent population. It is usually seen in immunocompromised hosts, those with human immunodeficiency virus (HIV) infection, malignancies, and patients on ... ...

Abstract	Esophagitis due to herpes simplex virus (HSV) infection is a rare entity in the immunocompetent population. It is usually seen in immunocompromised hosts, those with human immunodeficiency virus (HIV) infection, malignancies, and patients on immunosuppressive medications. We present a case of a young immunocompetent man with anabolic steroid use who presented with esophagitis symptoms found to be from HSV infection. So far, the use of corticosteroids has been reported as a predisposing factor for HSV esophagitis in immunocompetent hosts in multiple case reports. However, our case suspects that transient immunosuppression with similar medication can cause HSV esophagitis in otherwise immunocompetent hosts.
Language	English
Publishing date	2023-09-04
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.44668
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Esophageal Granular Cell Tumor: An Uncommon Cause of Dysphagia.

Revia, Richard A / Shah, Raj / Mandalia, Amar / Parikh, Jignesh / Zayat, Vania

Cureus

2023 Volume 15, Issue 7, Page(s) e41846

Abstract: Granular cell tumors (GCTs) are rare, typically benign, solitary neoplasms that can arise throughout the body, with reports of cases in the tongue, esophagus, colon, skin, vulva, and skeletal muscle, among others. Although GCTs are usually asymptomatic, ... ...

Abstract	Granular cell tumors (GCTs) are rare, typically benign, solitary neoplasms that can arise throughout the body, with reports of cases in the tongue, esophagus, colon, skin, vulva, and skeletal muscle, among others. Although GCTs are usually asymptomatic, esophageal GCTs can grow large enough to cause dysphagia. When developing the differential diagnosis for dysphagia, a broad consideration includes routine etiologies such as esophageal strictures, eosinophilic esophagitis, carcinoma, webs and rings, achalasia, and motility disorders, but GCTs may not readily come to mind. Due to their scarcity, this case report is presented to raise awareness of esophageal GCTs and emphasize key goals for diagnosing and managing this uncommon yet treatable cause of dysphagia. This case report details the clinical course of a patient presenting with a chief complaint of difficulty swallowing that was found to be caused by a subepithelial esophageal tumor discovered with esophagogastroduodenoscopy (EGD) and endoscopic ultrasound (EUS). Histopathological studies paired with immunohistochemical investigations of a tissue biopsy confirmed the etiology of the offending esophageal mass to be a GCT. The patient's dysphagia resolved after endoscopic mucosal resection of the GCT, and follow-up evaluations have remained negative for recurrence. This case highlights the esophageal GCT as an uncommon source of dysphagia and the need for EGD and EUS evaluations of subepithelial esophageal lesions accompanied by histopathological analysis for a definitive diagnosis of GCT.
Language	English
Publishing date	2023-07-13
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.41846
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Article ; Online: EXPRESS: Association of Statins with Onset and Progression of Non-Alcoholic Fatty Liver Disease in Patients with Diabetes.

Shah, Raj / Kong Ibanez, Alexander / De Melo, Silvio W / Boktor, Moheb / Henriquez, Richard / Mandalia, Amar / Samant, Hrishikesh / Alvarez, Carlos / Mansi, Ishak

Journal of investigative medicine : the official publication of the American Federation for Clinical Research

2024 , Page(s) 10815589241248076

Abstract: Non-alcoholic fatty liver disease (NAFLD) is the commonest cause of chronic liver disease in patients with diabetes; limited data suggested that statins may reduce the risk of NAFLD progression. This study aimed to examine the association between statins ...

Abstract	Non-alcoholic fatty liver disease (NAFLD) is the commonest cause of chronic liver disease in patients with diabetes; limited data suggested that statins may reduce the risk of NAFLD progression. This study aimed to examine the association between statins and the development or progression of NAFLD in veterans with diabetes. In a new-user negative control design, we conducted a retrospective propensity-score (PS) matched cohort study of patients with diabetes between 2003 and 2015. After excluding patients with other causes of liver disease, we formed PS using 85 characteristics. The primary outcome was a composite NAFLD progression outcome. Primary analysis examined odds of outcome in PS matched cohort. Post-hoc analysis included PS-matched cohort of statin users with intensive lowering of LDL-cholesterol versus low-intensity lowering. We matched 34,102 pairs from 300,739 statin users and 38,038 non-users. The composite outcome occurred in 8.8% of statin users and 8.6% of non-users (odds ratio [OR]: 1.02; 95% confidence interval [95%CI]: 0.97-1.08). In the post-hoc analysis, intensive lowering of LDL-cholesterol compared to low-intensity showed increased NAFLD progression (OR: 1.21, 95%CI: 1.13-1.30). This study showed that statin use in patients with diabetes was not associated with decreased or increased risk of NAFLD progression. Intensive LDL-cholesterol lowering compared to low-intensity LDL-cholesterol lowering was associated with an increased risk of NAFLD progression.
Language	English
Publishing date	2024-04-09
Publishing country	England
Document type	Journal Article
ZDB-ID	1217870-6
ISSN	1708-8267 ; 0009-9279 ; 1081-5589
ISSN (online)	1708-8267
ISSN	0009-9279 ; 1081-5589
DOI	10.1177/10815589241248076
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Article ; Online: Recent advances in understanding and managing acute pancreatitis.

Mandalia, Amar / Wamsteker, Erik-Jan / DiMagno, Matthew J

F1000Research

2018 Volume 7

Abstract: This review highlights advances made in recent years in the diagnosis and management of acute pancreatitis (AP). We focus on epidemiological, clinical, and management aspects of AP. Additionally, we discuss the role of using risk stratification tools to ... ...

Abstract	This review highlights advances made in recent years in the diagnosis and management of acute pancreatitis (AP). We focus on epidemiological, clinical, and management aspects of AP. Additionally, we discuss the role of using risk stratification tools to guide clinical decision making. The majority of patients suffer from mild AP, and only a subset develop moderately severe AP, defined as a pancreatic local complication, or severe AP, defined as persistent organ failure. In mild AP, management typically involves diagnostic evaluation and supportive care resulting usually in a short hospital length of stay (LOS). In severe AP, a multidisciplinary approach is warranted to minimize morbidity and mortality over the course of a protracted hospital LOS. Based on evidence from guideline recommendations, we discuss five treatment interventions, including intravenous fluid resuscitation, feeding, prophylactic antibiotics, probiotics, and timing of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis. This review also highlights the importance of preventive interventions to reduce hospital readmission or prevent pancreatitis, including alcohol and smoking cessation, same-admission cholecystectomy for acute biliary pancreatitis, and chemoprevention and fluid administration for post-ERCP pancreatitis. Our review aims to consolidate guideline recommendations and high-quality studies published in recent years to guide the management of AP and highlight areas in need of research.
MeSH term(s)	Acute Disease/epidemiology ; Humans ; Pancreatitis/drug therapy ; Pancreatitis/epidemiology ; Pancreatitis/surgery ; Pancreatitis/therapy
Language	English
Publishing date	2018-06-28
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	2699932-8
ISSN	2046-1402 ; 2046-1402
ISSN (online)	2046-1402
ISSN	2046-1402
DOI	10.12688/f1000research.14244.2
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Article ; Online: Clinical Images: Black Esophagus in Antiphospholipid Syndrome.

Padda, Amrita / Mandalia, Amar / Sawalha, Amr H

Arthritis & rheumatology (Hoboken, N.J.)

2017 Volume 69, Issue 7, Page(s) 1460

MeSH term(s)	Antiphospholipid Syndrome/complications ; Antiphospholipid Syndrome/diagnostic imaging ; Esophageal Diseases/diagnostic imaging ; Esophageal Diseases/immunology ; Esophagoscopy ; Esophagus/diagnostic imaging ; Esophagus/immunology ; Esophagus/pathology ; Female ; Humans ; Medical Illustration ; Middle Aged ; Necrosis
Language	English
Publishing date	2017-05-23
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2756371-6
ISSN	2326-5205 ; 2326-5191
ISSN (online)	2326-5205
ISSN	2326-5191
DOI	10.1002/art.40092
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Article ; Online: Recent advances in understanding and managing acute pancreatitis [version 1; referees

Amar Mandalia / Erik-Jan Wamsteker / Matthew DiMagno

F1000Research, Vol

2 approved]

2018 Volume 7

Abstract	This review highlights advances made in recent years in the diagnosis and management of acute pancreatitis (AP). We focus on epidemiological, clinical, and management aspects of AP. Additionally, we discuss the role of using risk stratification tools to guide clinical decision making. The majority of patients suffer from mild AP, and only a subset develop moderately severe AP, defined as a pancreatic local complication, or severe AP, defined as persistent organ failure. In mild AP, management typically involves diagnostic evaluation and supportive care resulting usually in a short hospital length of stay (LOS). In severe AP, a multidisciplinary approach is warranted to minimize morbidity and mortality over the course of a protracted hospital LOS. Based on evidence from guideline recommendations, we discuss five treatment interventions, including intravenous fluid resuscitation, feeding, prophylactic antibiotics, probiotics, and timing of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis. This review also highlights the importance of preventive interventions to reduce hospital readmission or prevent pancreatitis, including alcohol and smoking cessation, same-admission cholecystectomy for acute biliary pancreatitis, and chemoprevention and fluid administration for post-ERCP pancreatitis. Our review aims to consolidate guideline recommendations and high-quality studies published in recent years to guide the management of AP and highlight areas in need of research.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2018-06-01T00:00:00Z
Publisher	F1000 Research Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Recent advances in understanding and managing acute pancreatitis [version 2; referees

Amar Mandalia / Erik-Jan Wamsteker / Matthew J. DiMagno

F1000Research, Vol

2 approved]

2019 Volume 7

Abstract	This review highlights advances made in recent years in the diagnosis and management of acute pancreatitis (AP). We focus on epidemiological, clinical, and management aspects of AP. Additionally, we discuss the role of using risk stratification tools to guide clinical decision making. The majority of patients suffer from mild AP, and only a subset develop moderately severe AP, defined as a pancreatic local complication, or severe AP, defined as persistent organ failure. In mild AP, management typically involves diagnostic evaluation and supportive care resulting usually in a short hospital length of stay (LOS). In severe AP, a multidisciplinary approach is warranted to minimize morbidity and mortality over the course of a protracted hospital LOS. Based on evidence from guideline recommendations, we discuss five treatment interventions, including intravenous fluid resuscitation, feeding, prophylactic antibiotics, probiotics, and timing of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis. This review also highlights the importance of preventive interventions to reduce hospital readmission or prevent pancreatitis, including alcohol and smoking cessation, same-admission cholecystectomy for acute biliary pancreatitis, and chemoprevention and fluid administration for post-ERCP pancreatitis. Our review aims to consolidate guideline recommendations and high-quality studies published in recent years to guide the management of AP and highlight areas in need of research.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	F1000 Research Ltd
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Diverticulitis after fecal microbiota transplant for C. difficile infection.

Mandalia, Amar / Kraft, Colleen S / Dhere, Tanvi

The American journal of gastroenterology

2014 Volume 109, Issue 12, Page(s) 1956–1957

MeSH term(s)	Aged ; Colon, Sigmoid/diagnostic imaging ; Diverticulitis, Colonic/diagnostic imaging ; Diverticulitis, Colonic/etiology ; Enterocolitis, Pseudomembranous/therapy ; Feces/microbiology ; Female ; Humans ; Microbiota ; Tomography, X-Ray Computed ; Transplantation/adverse effects
Language	English
Publishing date	2014-12
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.1038/ajg.2014.350
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Fecal transplant is as effective and safe in immunocompromised as non-immunocompromised patients for Clostridium difficile.

Mandalia, Amar / Ward, Angela / Tauxe, William / Kraft, Colleen S / Dhere, Tanvi

International journal of colorectal disease

2015 Volume 31, Issue 5, Page(s) 1059–1060

MeSH term(s)	Clostridium difficile/physiology ; Enterocolitis, Pseudomembranous/therapy ; Fecal Microbiota Transplantation/adverse effects ; Follow-Up Studies ; Humans ; Immunocompromised Host
Language	English
Publishing date	2015-09-26
Publishing country	Germany
Document type	Letter
ZDB-ID	84975-3
ISSN	1432-1262 ; 0179-1958
ISSN (online)	1432-1262
ISSN	0179-1958
DOI	10.1007/s00384-015-2396-2
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Article ; Online: Predictive factors for clinically actionable computed tomography findings in inflammatory bowel disease patients seen in the emergency department with acute gastrointestinal symptoms.

Yarur, Andres J / Mandalia, Amar B / Dauer, Ryan M / Czul, Frank / Deshpande, Amar R / Kerman, David H / Abreu, Maria T / Sussman, Daniel A

Journal of Crohn's & colitis

2014 Volume 8, Issue 6, Page(s) 504–512

Abstract: Background: The wide use of abdomino-pelvic computed tomography (APCT) in emergency departments (ED) has raised the concern for radiation exposure, costs and potential reactions to contrast agents. The aim of this study was to determine the yield and ... ...

Abstract	Background: The wide use of abdomino-pelvic computed tomography (APCT) in emergency departments (ED) has raised the concern for radiation exposure, costs and potential reactions to contrast agents. The aim of this study was to determine the yield and predictive factors for clinically actionable findings (CAF) in APCTs performed in patients with inflammatory bowel disease (IBD) who visit the ED. Methods: We performed a cross-sectional study including patients with IBD who visited the ED. Variables considered were demographics, IBD phenotype, clinical symptoms, IBD medication use prior to ED visit, laboratory values, and imaging results. The primary outcome was a composite of CAF, defined as new, intra-abdominal abscess or tumor, bowel obstruction, fistulae, diverticulitis, choledocholithiasis, or appendicitis. Results: 354 patients were included. One or more CAF were reported in 26.6% of the APCTs (32.1% in CD and 12.8% in UC [p<0.01]). Independent predictive variables of CAF in CD were: CRP level ≥5mg/dl (p=0.04), previous history of IBD surgery (p=0.037), Black race (p<0.01) and low body mass index (p<0.01). None of the study variables predicted CAF in UC. Conclusions: The yield for CAF with APCT in the ED was high for CD patients but minimal for those with UC and was not improved by the use of contrast. Elevated CRP, low BMI, Black race and previous history of IBD surgery predicted CAF in CD but no variables were predictive of CAF in UC.
MeSH term(s)	Acute Disease ; Adult ; Colitis, Ulcerative/complications ; Colitis, Ulcerative/diagnostic imaging ; Crohn Disease/complications ; Crohn Disease/diagnostic imaging ; Cross-Sectional Studies ; Emergencies ; Emergency Service, Hospital/statistics & numerical data ; Female ; Gastrointestinal Diseases/diagnostic imaging ; Gastrointestinal Diseases/etiology ; Humans ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/diagnostic imaging ; Male ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed
Language	English
Publishing date	2014-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2390120-2
ISSN	1876-4479 ; 1873-9946
ISSN (online)	1876-4479
ISSN	1873-9946
DOI	10.1016/j.crohns.2013.11.003
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