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Article: Racial Disparity in HCV Demographics and Treatment Between Interferon Era (2002-2003) and Direct Acting Anti-viral Era (2019).

Naylor, Paul / Minawala, Ria / Wong, Katherine / Ehrinpreis, Murray N / Mutchnick, Milton

2023 Volume 15, Issue 3, Page(s) e36643

Abstract: Introduction Direct-acting antiviral (DAA) treatment increased the sustained viral response (SVR) rate of patients with the hepatitis C virus (HCV) and eliminated response disparities between African American (AA) and non-AA patients seen with ... ...

Abstract	Introduction Direct-acting antiviral (DAA) treatment increased the sustained viral response (SVR) rate of patients with the hepatitis C virus (HCV) and eliminated response disparities between African American (AA) and non-AA patients seen with interferon (IFN). The aim of this study was to compare 2019 HCV patients (DAA era) to patients from January 1, 2002 and December 31, 2003 (IFN era) in our predominantly AA clinic population. Methods We extracted data on 585 HCV patients seen in 2019 (DAA era) and compared them to 402 patients seen in the IFN era. Results Most HCV patients were born between 1945 and 1965, but in the DAA era more younger patients were identified. Non-AA patients in both eras were less likely to be infected with genotype 1 compared to AA (95% vs 54%, P<0.001). Fibrosis was not increased in the DAA Era as compared to the IFN era as assessed either by serum-based assays (APRI, FIB-4) or transient elastography (FibroScan) (DAA era) vs biopsy (IFN era). More patients were treated in 2019 compared to 2002-2003 (159/585=27% vs 5/402=1%). For untreated patients, subsequent treatment within one year of the initial visit was low and similar in both eras (35%). Conclusion There continues to be a need to screen patients born between 1945 and 1965 for HCV as well as to identify increasing numbers of patients below this age cohort. Even though current therapies are oral, highly effective, and can be 8-12 weeks in duration, significant numbers of patients were not treated within a year of first visit.
Language	English
Publishing date	2023-03-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.36643
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Ipilimumab and Nivolumab-Induced Colitis in a Patient With Recurrent Metastatic Melanoma.

Moein, Hamid-Reza / Rutledge, Brian / Beydoun, Rafic / Ehrinpreis, Murray N

Cureus

2021 Volume 13, Issue 4, Page(s) e14414

Abstract: Ipilimumab and nivolumab are immune checkpoint inhibitors that have recently been used in the treatment of metastatic melanoma and other cancers. Immune-mediated colitis is one of their adverse events that need to be differentiated from low-grade ... ...

Abstract	Ipilimumab and nivolumab are immune checkpoint inhibitors that have recently been used in the treatment of metastatic melanoma and other cancers. Immune-mediated colitis is one of their adverse events that need to be differentiated from low-grade diarrhea as one of the most common side effects. A 51-year-old woman with relapsed metastatic melanoma presented with intractable diarrhea, nausea, vomiting, and generalized abdominal pain. The patient had been treated with ipilimumab and nivolumab in the past two months. The infectious workup was inconclusive. Colonoscopy demonstrated severe colitis, and biopsies were consistent with colitis. Combination chemotherapy was stopped. The patient was treated with intravenous and oral steroids, and her symptoms improved. A combination of ipilimumab and nivolumab increases the chance of immune-mediated colitis, and steroids should be started promptly to avoid complications such as bowel perforation and toxic megacolon.
Language	English
Publishing date	2021-04-11
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.14414
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Celiac Disease Patients With Coronary Artery Disease: A Nationwide Population-Based Study.

Haider, Maryam B / Naylor, Paul / Das, Avijit / Haider, Syed M / Ehrinpreis, Murray N

Cureus

2022 Volume 14, Issue 6, Page(s) e26151

Abstract: Background Coronary artery disease (CAD) is associated with celiac disease (CD) with limited evidence. However, the common risk factors linking CD and CAD are still lacking in the literature. Known CAD risk factors include hypertension, hyperlipidemia, ... ...

Abstract	Background Coronary artery disease (CAD) is associated with celiac disease (CD) with limited evidence. However, the common risk factors linking CD and CAD are still lacking in the literature. Known CAD risk factors include hypertension, hyperlipidemia, type 2 diabetes, obesity, and tobacco use. Common risk factors linking CD and CAD are poorly documented. Objective There are three objectives: Firstly, to evaluate potential demographic differences between CD patients with CAD and without CAD. Secondly, to analyze the risk factors of CAD in CD patients. Lastly, to compare CD-CAD and matched non-CD CAD to determine whether there are additional CAD risks in individuals with CD. Methods The study is a nationwide retrospective case-control study. The National Inpatient Sample (NIS) database was used to identify patients admitted between 2016 and 2018 with a principal or secondary diagnosis of CD. We analyzed sociodemographic and clinical risk factors of CAD in CD patients and compared the CD-CAD population with the matched non-CD CAD cohort. Results Out of 23,441 hospitalizations with CD in 2016-2018, 4244 (18%) were found to have CAD. Established CAD risk factors identified in CD patients included hypertension, hyperlipidemia, type 2 diabetes, and a family history of CAD. In contrast, tobacco use is not a CAD risk factor in CD patients. Female patients with CD had 55% lesser odds of CAD than male patients. The odds of CAD in CD patients with hyperlipidemia were five times higher, 1.2 times higher with essential hypertension, and two times higher with type 2 diabetes. Patients with CAD had a higher prevalence of iron deficiency anemia (9.33% CD-CAD and 8.28% non-CAD CD Vs. 7.32% non-CD CAD). Conclusions Our study confirms that, as with non-CD individuals, males and the White race are at increased CAD risk in the CD population. CD-CAD patients have a higher hyperlipidemia prevalence than non-CD CAD patients. CD patients with type 1 diabetes have an early diagnosis of CAD compared to CD patients with type 2 diabetes. Iron deficiency anemia is a statistically significant risk factor for CAD in CD patients.
Language	English
Publishing date	2022-06-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.26151
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Wilkie's Syndrome following Chemotherapy: A Case Report and a Review of Literature.

Corsi, Nicholas J / Abu-Heija, Ahmad A / Ravi, Anand Kumar / Corsi, Matthew P / Ehrinpreis, Murray N

Case reports in gastrointestinal medicine

2022 Volume 2022, Page(s) 7783074

Abstract: Superior mesenteric artery (SMA) syndrome is a rare etiology of upper gastrointestinal obstruction. The measured angle between the SMA and the aorta is typically between 38 and 65° and maintained by mesenteric fat. Excessive fat loss can lead to ... ...

Abstract	Superior mesenteric artery (SMA) syndrome is a rare etiology of upper gastrointestinal obstruction. The measured angle between the SMA and the aorta is typically between 38 and 65° and maintained by mesenteric fat. Excessive fat loss can lead to intestinal obstruction due to an exaggerated acute angularity of the SMA, compressing the third part of the duodenum. We present a 22-year-old female with a history of aplastic anemia, status post bone-marrow transplant, who presented with intractable nausea and had confirmed SMA syndrome on CT angiography. Subsequently, the patient underwent nasogastric decompression and successful laparoscopic duodenojejunostomy.
Language	English
Publishing date	2022-07-22
Publishing country	United States
Document type	Case Reports
ZDB-ID	2627636-7
ISSN	2090-6536 ; 2090-6528
ISSN (online)	2090-6536
ISSN	2090-6528
DOI	10.1155/2022/7783074
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Pembrolizumab-Induced Immune-Mediated Hepatitis and Concurrent Hepatitis B Reactivation in a Patient With Non-Small Cell Lung Cancer.

Kundumadam, Shanker / Mohamad, Bashar / Muthusamy, Arun / Kathi, Pradeep R / Ehrinpreis, Murray N

Cureus

2020 Volume 12, Issue 11, Page(s) e11522

Abstract: New immuno-therapeutic agents like pembrolizumab used in cancer treatment are known to cause immune-mediated hepatitis. Most of these cases are straightforward when the onset of transaminitis correlates with the introduction of the medication. This agent ...

Abstract	New immuno-therapeutic agents like pembrolizumab used in cancer treatment are known to cause immune-mediated hepatitis. Most of these cases are straightforward when the onset of transaminitis correlates with the introduction of the medication. This agent causing hepatitis B reactivation has been reported only once. To have both these adverse effects occurring at the same time in a patient is uncommon and presents a clinical challenge. Our patient was a 49-year-old gentleman diagnosed with metastatic adenocarcinoma of the lung seven months ago. He was started on pembrolizumab, as the malignant tissue obtained during biopsy had high program death-ligand 1 (PDL1) expression. On reviewing the labs ordered during the time of cancer diagnosis, this man has evidence of chronic hepatitis B with positive hepatitis B surface antigen and positive hepatitis B core immunoglobulin G (IgG) antibody. He presented with acute hepatitis, and workup showed features of hepatitis B reactivation, but the extent of reactivation was not adequate to explain the presentation, hence investigations were pursued. This led the way to the diagnosis of a combined hepatitis B reactivation and drug-induced immune hepatitis in this case. He responded promptly to the withdrawal of the agent and steroids. On follow-up, his liver function panel had significantly improved. This case is very unique in two aspects. First, to our knowledge, there is only one case reported of pembrolizumab-induced hepatitis B reactivation. In addition, our patient also had immune-mediated hepatitis induced by pembrolizumab. It is very rare to have a combination of these two presentations to be seen in a patient at the same time. Pembrolizumab-induced immune hepatitis can coexist with hepatitis B reactivation following therapy with this agent.
Language	English
Publishing date	2020-11-17
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.11522
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Peripheral T-Cell Lymphoma Presenting as Pseudoachalasia.

Kathi, Pradeep Reddy / Thammineni, Nikhila / Pathai, Lakshmi / Alosh, Baraa / Ehrinpreis, Murray N

The American journal of gastroenterology

2019 Volume 115, Issue 2, Page(s) 161

MeSH term(s)	Adrenal Cortex Hormones/therapeutic use ; Aged ; Deglutition Disorders/etiology ; Diagnosis, Differential ; Endosonography ; Esophageal Achalasia/diagnosis ; Esophagogastric Junction/diagnostic imaging ; Humans ; Lymphadenopathy/complications ; Lymphadenopathy/diagnostic imaging ; Lymphadenopathy/pathology ; Lymphoma, T-Cell, Peripheral/complications ; Lymphoma, T-Cell, Peripheral/diagnostic imaging ; Lymphoma, T-Cell, Peripheral/drug therapy ; Lymphoma, T-Cell, Peripheral/pathology ; Male ; Tomography, X-Ray Computed
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2019-07-16
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.14309/ajg.0000000000000353
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Acute Gastrointestinal Bleeding Due to Cytomegalovirus Colitis in a Patient with Common Variable Immunodeficiency.

Kathi, Pradeep / Tama, Maher / Reddy, Vivek / Kundumadam, Shankerdas / Al-Subee, Omar / Ehrinpreis, Murray N

ACG case reports journal

2018 Volume 5, Page(s) e40

Abstract: Common variable immunodeficiency (CVID) is a heterogeneous disorder with decreased production of immunoglobulins that presents with recurrent and serious infections in ∼90% of cases. Review of the literature showed only 12 cases of gastrointestinal ... ...

Abstract	Common variable immunodeficiency (CVID) is a heterogeneous disorder with decreased production of immunoglobulins that presents with recurrent and serious infections in ∼90% of cases. Review of the literature showed only 12 cases of gastrointestinal infection of cytomegalovirus in patients with CVID. We present an unusual case of a CVID patient presenting with new-onset hematochezia. With proper clinical suspicion and endoscopic evaluation, cytomegalovirus colitis was diagnosed and acute bleeding was successfully treated endoscopically.
Language	English
Publishing date	2018-05-23
Publishing country	United States
Document type	Case Reports
ZDB-ID	2814825-3
ISSN	2326-3253
ISSN	2326-3253
DOI	10.14309/crj.2018.40
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Esophageal arteriovenous malformation, a rare cause of significant upper gastrointestinal bleeding: Case report and review of literature.

Kathi, Pradeep Reddy / Tama, Maher / Kundumadam, Shankerdas / Gulati, Dhiraj / Ehrinpreis, Murray N

Intractable & rare diseases research

2018 Volume 7, Issue 3, Page(s) 196–199

Abstract: Gastrointestinal (GI) arteriovenous malformations (AVMs) are a well-known source of bleeding with colon being the most common site, but they can also occur in rare locations like the esophagus which may present with life threatening bleeding. We report ... ...

Abstract	Gastrointestinal (GI) arteriovenous malformations (AVMs) are a well-known source of bleeding with colon being the most common site, but they can also occur in rare locations like the esophagus which may present with life threatening bleeding. We report the case of a 51-year-old male with end stage renal disease (ESRD) presenting with hematemesis and acute on chronic anemia. Further investigation showed an esophageal AVM which is an unusual location and it was successfully treated with an endoscopic clip instead of argon plasma coagulation (APC) due to its challenging location and esophageal wall motion from breathing. The patient continued to be asymptomatic without any upper and lower GI bleeding during his 20 months follow up period after the endoscopic management. Review of literature showed only 10 cases of AVMs involving esophagus and the average age of presentation was 52 years with a male predominance. We also provide an overview of those cases in the discussion section below.
Language	English
Publishing date	2018-06-30
Publishing country	Japan
Document type	Case Reports
ZDB-ID	2672570-8
ISSN	2186-361X ; 2186-3644
ISSN (online)	2186-361X
ISSN	2186-3644
DOI	10.5582/irdr.2018.01068
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Should the national GI fellowship matching program be restored? Con: The gastroenterology fellowship match: R.I.P.

Ehrinpreis, Murray N

The American journal of gastroenterology

2003 Volume 99, Issue 1, Page(s) 7–9

MeSH term(s)	Fellowships and Scholarships ; Gastroenterology/education ; United States
Language	English
Publishing date	2003-11-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.1111/j.1572-0241.2004.04030.x
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Clostridium difficile-associated diarrhea and proton pump inhibitor therapy: a meta-analysis.

Janarthanan, Sailajah / Ditah, Ivo / Adler, Douglas G / Ehrinpreis, Murray N

The American journal of gastroenterology

2012 Volume 107, Issue 7, Page(s) 1001–1010

Abstract: Objectives: Clostridium difficile-associated diarrhea (CDAD) is a major cause of morbidity and increasing health-care costs among hospitalized patients. Although exposure to antibiotics remains the most documented risk factor for CDAD, attention has ... ...

Abstract	Objectives: Clostridium difficile-associated diarrhea (CDAD) is a major cause of morbidity and increasing health-care costs among hospitalized patients. Although exposure to antibiotics remains the most documented risk factor for CDAD, attention has recently been directed toward a plausible link with proton pump inhibitors (PPIs). However, the results of studies on the association between CDAD and PPIs remain controversial. We have conducted a meta-analysis to summarize the association between PPIs and CDAD among hospitalized patients. Methods: A systematic search of published literature on studies that investigated the association between PPIs and CDAD from 1990 to 2010 was conducted on Medline and PubMed. The identified articles were reviewed for additional references. The most adjusted risk estimates were extracted by two authors and summarized using random effects meta-analysis. We also conducted a subgroup analysis by study design. Publication bias was evaluated using the Begg and Egger tests. A sensitivity analysis using the Duval and Tweedie "trim-and-fill" method has also been performed. Results: Twenty-three studies including close to 300,000 patients met the inclusion criteria. There was a 65% (summary risk estimate 1.69 with a 95% confidence interval (CI) from 1.395 to 1.974; P<0.000) increase in the incidence of CDAD among patients on PPIs. By study design, whether case-control study (17) or cohort study (6), there was still a significant increase in the incidence of CDAD among PPI users. The risk estimates were 2.31 (95% CI from 1.72 to 3.10; P<0.001) and 1.48 (95% CI from 1.25 to 1.75; P<0.001) for cohort and case-control studies, respectively. Conclusions: There is sufficient evidence to suggest that PPIs increase the incidence of CDAD. Our meta-analysis shows a 65% increase in the incidence of CDAD among PPI users. We recommend that the routine use of PPIs for gastric ulcer prophylaxis should be more prudent. Establishing a guideline for the use of PPI may help in the future with the judicious use of PPIs. Further studies, preferably prospective, are needed to fully explore the association between PPIs and CDAD.
MeSH term(s)	Anti-Bacterial Agents/adverse effects ; Clostridium difficile ; Enterocolitis, Pseudomembranous/chemically induced ; Enterocolitis, Pseudomembranous/epidemiology ; Humans ; Incidence ; Proton Pump Inhibitors/adverse effects ; Risk Factors
Chemical Substances	Anti-Bacterial Agents ; Proton Pump Inhibitors
Language	English
Publishing date	2012-07
Publishing country	United States
Document type	Journal Article ; Meta-Analysis
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.1038/ajg.2012.179
Database	MEDical Literature Analysis and Retrieval System OnLINE

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