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  1. Article: Acute Esophageal Necrosis: A Case of Black Esophagus Associated with Bismuth Subsalicylate Ingestion.

    Abed, Jean / Mankal, Pavan / Judeh, Hani / Kim, Sang

    ACG case reports journal

    2014  Volume 1, Issue 3, Page(s) 131–133

    Abstract: We present a case of acute esophageal necrosis (AEN) likely caused by chronic use of bismuth subsalicylate, an active ingredient in over-the-counter Pepto-Bismol(®), which contains 220 g of salicylic acid in each 30 mL quantity. While aspirin is known to ...

    Abstract We present a case of acute esophageal necrosis (AEN) likely caused by chronic use of bismuth subsalicylate, an active ingredient in over-the-counter Pepto-Bismol(®), which contains 220 g of salicylic acid in each 30 mL quantity. While aspirin is known to cause gastritis and gastric ulcers, this is the first case, to our knowledge, reporting AEN after chronic bismuth subsalicylate use.
    Language English
    Publishing date 2014-04-04
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2814825-3
    ISSN 2326-3253
    ISSN 2326-3253
    DOI 10.14309/crj.2014.27
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: The "starry sky" liver with right-sided heart failure.

    Abu-Judeh, Hani H

    AJR. American journal of roentgenology

    2002  Volume 178, Issue 1, Page(s) 78

    MeSH term(s) Adult ; Diagnosis, Differential ; Edema/diagnostic imaging ; Heart Failure/diagnostic imaging ; Hepatic Veins/diagnostic imaging ; Humans ; Liver Diseases/diagnostic imaging ; Male ; Portal Vein/diagnostic imaging ; Tomography, X-Ray Computed ; Tricuspid Valve Insufficiency/diagnostic imaging ; Ultrasonography ; Ventricular Dysfunction, Right/diagnostic imaging ; Venules/diagnostic imaging
    Language English
    Publishing date 2002-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 82076-3
    ISSN 1546-3141 ; 0361-803X ; 0092-5381
    ISSN (online) 1546-3141
    ISSN 0361-803X ; 0092-5381
    DOI 10.2214/ajr.178.1.1780078
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  3. Article: “Fixing a heart”: the game of electrolytes in anorexia nervosa

    Abed, Jean / Judeh, Hani / Abed, Elie / Kim, Matthew / Arabelo, Haword / Gurunathan, Rajan

    Nutrition journal. 2014 Dec., v. 13, no. 1

    2014  

    Abstract: CASE: A 25-year-old woman with chronic anorexia nervosa and depression presented with sudden weakness and fatigue. Psychosocial history was notable for binge-starve cycles over the past year and a decline in overall well-being. Vitals on presentation ... ...

    Abstract CASE: A 25-year-old woman with chronic anorexia nervosa and depression presented with sudden weakness and fatigue. Psychosocial history was notable for binge-starve cycles over the past year and a decline in overall well-being. Vitals on presentation were notable for hypothermia, hypotension, and bradycardia. Initial exam was significant for emaciation, lethargy, and lower extremity edema. Laboratory work-up revealed markedly elevated LFTs, hypoglycemia, thrombocytopenia and elevated INR and lipase. ECG showed sinus bradycardia with prolonged QTc. Ultrasound revealed normal liver and biliary tree. Serum acetaminophen, alcohol level, and urinary toxicology were unremarkable. Work up for infectious, autoimmune, and genetic causes of hepatitis was negative. Echocardiogram revealed left ventricular hypokinesis and EF 10-15%. Nutritional support was begun slowly, however electrolyte derangements began to manifest on hospital day 2, with hypophosphatemia, hypokalemia, hypocalcemia, and hypomagnesemia. Multiple medical and psychiatric disciplines were consulted, and aggressive electrolyte monitoring and repletion were done. The patient’s overall clinical status improved slowly during her hospital course. Her liver enzymes trended down, and her QTc interval eventually returned toward the normal range. Repeat echocardiogram following treatment revealed improvement of her EF to 40%. DISCUSSION: Anorexia nervosa is an eating disorder characterized by extremely low body weight, fear of gaining weight or distorted perception of body image, and amenorrhea. Anorexia can lead to life threatening medical complications, and thus constitutes a major challenge to manage. Central to the pathogenesis of the refeeding syndrome is a weakened cardiopulmonary system, electrolytes abnormalities, hepatic dysfunction, liver hypoperfusion and failure. CONCLUSION: Given the clinical presentation, this patient likely presented on the brink of developing frank refeeding syndrome, with cardiac dysfunction and hypovolemia, leading to hepatic hypoperfusion and ischemic hepatitis. Subsequently, she developed electrolyte disturbances characteristic of refeeding syndrome, which were managed without major complication. Her hospital course is encouraging not only for her recovery, but for the collaboration of the different teams involved in her care, and it highlights the importance of a multidisciplinary approach to caring for patients with the potential dire complications of a complex psychiatric illness.
    Keywords acetaminophen ; alcohols ; amenorrhea ; anorexia ; anorexia nervosa ; biliary tract ; blood serum ; body image ; edema ; electrolytes ; emaciation ; enzymes ; fearfulness ; gaining weight ; heart ; hepatitis ; hypocalcemia ; hypoglycemia ; hypokalemia ; hypomagnesemia ; hypotension ; hypothermia ; hypovolemic shock ; liver ; monitoring ; nutritional support ; pathogenesis ; patients ; refeeding ; repletion ; teams ; thrombocytopenia ; toxicology ; ultrasonics ; women
    Language English
    Dates of publication 2014-12
    Size p. 825.
    Publishing place Springer-Verlag
    Document type Article
    ZDB-ID 2091602-4
    ISSN 1475-2891
    ISSN 1475-2891
    DOI 10.1186/1475-2891-13-90
    Database NAL-Catalogue (AGRICOLA)

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  4. Article ; Online: "Fixing a heart": the game of electrolytes in anorexia nervosa.

    Abed, Jean / Judeh, Hani / Abed, Elie / Kim, Matthew / Arabelo, Haword / Gurunathan, Rajan

    Nutrition journal

    2014  Volume 13, Page(s) 90

    Abstract: Case: A 25-year-old woman with chronic anorexia nervosa and depression presented with sudden weakness and fatigue. Psychosocial history was notable for binge-starve cycles over the past year and a decline in overall well-being. Vitals on presentation ... ...

    Abstract Case: A 25-year-old woman with chronic anorexia nervosa and depression presented with sudden weakness and fatigue. Psychosocial history was notable for binge-starve cycles over the past year and a decline in overall well-being. Vitals on presentation were notable for hypothermia, hypotension, and bradycardia. Initial exam was significant for emaciation, lethargy, and lower extremity edema. Laboratory work-up revealed markedly elevated LFTs, hypoglycemia, thrombocytopenia and elevated INR and lipase. ECG showed sinus bradycardia with prolonged QTc. Ultrasound revealed normal liver and biliary tree. Serum acetaminophen, alcohol level, and urinary toxicology were unremarkable. Work up for infectious, autoimmune, and genetic causes of hepatitis was negative. Echocardiogram revealed left ventricular hypokinesis and EF 10-15%. Nutritional support was begun slowly, however electrolyte derangements began to manifest on hospital day 2, with hypophosphatemia, hypokalemia, hypocalcemia, and hypomagnesemia. Multiple medical and psychiatric disciplines were consulted, and aggressive electrolyte monitoring and repletion were done. The patient's overall clinical status improved slowly during her hospital course. Her liver enzymes trended down, and her QTc interval eventually returned toward the normal range. Repeat echocardiogram following treatment revealed improvement of her EF to 40%.
    Discussion: Anorexia nervosa is an eating disorder characterized by extremely low body weight, fear of gaining weight or distorted perception of body image, and amenorrhea. Anorexia can lead to life threatening medical complications, and thus constitutes a major challenge to manage. Central to the pathogenesis of the refeeding syndrome is a weakened cardiopulmonary system, electrolytes abnormalities, hepatic dysfunction, liver hypoperfusion and failure.
    Conclusion: Given the clinical presentation, this patient likely presented on the brink of developing frank refeeding syndrome, with cardiac dysfunction and hypovolemia, leading to hepatic hypoperfusion and ischemic hepatitis. Subsequently, she developed electrolyte disturbances characteristic of refeeding syndrome, which were managed without major complication. Her hospital course is encouraging not only for her recovery, but for the collaboration of the different teams involved in her care, and it highlights the importance of a multidisciplinary approach to caring for patients with the potential dire complications of a complex psychiatric illness.
    MeSH term(s) Adult ; Alanine Transaminase/blood ; Anorexia Nervosa/blood ; Anorexia Nervosa/complications ; Anorexia Nervosa/psychology ; Anorexia Nervosa/therapy ; Aspartate Aminotransferases/blood ; Electrolytes/blood ; Female ; Heart/physiology ; Humans ; Nutritional Support/methods ; Refeeding Syndrome/etiology ; Refeeding Syndrome/therapy ; Treatment Outcome ; Water-Electrolyte Imbalance/blood ; Water-Electrolyte Imbalance/etiology ; Water-Electrolyte Imbalance/therapy
    Chemical Substances Electrolytes ; Aspartate Aminotransferases (EC 2.6.1.1) ; Alanine Transaminase (EC 2.6.1.2)
    Language English
    Publishing date 2014-09-05
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1475-2891
    ISSN (online) 1475-2891
    DOI 10.1186/1475-2891-13-90
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Pillcam ESO(®) is more accurate than clinical scoring systems in risk stratifying emergency room patients with acute upper gastrointestinal bleeding.

    Gutkin, Ellen / Shalomov, Albert / Hussain, Syed A / Kim, Sang H / Cortes, Rafael / Gray, Sondra / Judeh, Hani / Pollack, Simcha / Rubin, Moshe

    Therapeutic advances in gastroenterology

    2013  Volume 6, Issue 3, Page(s) 193–198

    Abstract: Background: Upper gastrointestinal bleeding (UGIB) accounts for 400,000 hospital admissions in the US each year. Despite advances, mortality rates remain high and are estimated to be 5-10%. Early therapeutic endoscopy is widely recommended as a means of ...

    Abstract Background: Upper gastrointestinal bleeding (UGIB) accounts for 400,000 hospital admissions in the US each year. Despite advances, mortality rates remain high and are estimated to be 5-10%. Early therapeutic endoscopy is widely recommended as a means of reducing morbidity and mortality. The Rockall and Blatchford scores are clinical scoring systems devised to assist in risk stratifying patients with UGIB. In a prior study we found that rapid live bedside video capsule endoscopy (VCE) utilizing Pillcam ESO(®) correctly identified patients with high-risk stigmata of bleeding seen on upper endoscopy. In this study, we compare the accuracy of the Rockall and Blatchford scores with Pillcam ESO(®) in predicting high-risk endoscopic stigmata.
    Methods: Pre-endoscopy Blatchford and Rockall scores were calculated for 25 patients (14 males, 11 females) presenting to the emergency room with acute UGIB. The average patient was 66 years of age. A total of 24 out of 25 patients underwent upper endoscopy within 24 hours. One patient did not undergo endoscopy due to clinical instability. The timing of endoscopy was based on clinical parameters in 12 patients, and on live view VCE with Pillcam ESO(®) in the other 13 patients. Positive VCE was defined as red blood, clot or coffee grounds. Mean Rockall and Blatchford scores for all 24 patients were compared to determine potential differences between high- and low-risk patients. Rockall and Blatchford scores were also compared with VCE findings.
    Results: Of 24 patients, 13 had high-risk stigmata on upper endoscopy. The mean Rockall and Blatchford scores were 3 and 13, respectively. In the 11 patients without stigmata, the mean Rockall and Blatchford scores were 2 and 11, respectively. There was no statistically significant difference between the Blatchford scores of the two groups (95% confidence interval [CI] -5.1 to 1.3; p = 0.22). There was no statistically significant difference between the Rockall scores of the two groups (95% CI -2.3 to 0.3; p = 0.11). In the subgroup of 12 patients who underwent VCE prior to endoscopy, 8/12 had positive findings, which were all confirmed at endoscopy. All 4 patients with negative VCE had no high-risk stigmata at endoscopy.
    Conclusion: In emergency room patients with acute UGIB, neither the Rockall nor the Blatchford scores were able to differentiate high- and low-risk patients identified at endoscopy. Live view VCE, however, was accurate in predicting high-risk endoscopic stigmata, and may be better suited as a risk stratification tool. Additional studies with a larger cohort will be required to validate these findings.
    Language English
    Publishing date 2013-04-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2440710-0
    ISSN 1756-2848 ; 1756-283X
    ISSN (online) 1756-2848
    ISSN 1756-283X
    DOI 10.1177/1756283X13481020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: “Fixing a heart”: the game of electrolytes in anorexia nervosa

    Abed, Jean / Judeh, Hani / Abed, Elie / Kim, Matthew / Arabelo, Haword / Gurunathan, Rajan

    Nutrition journal

    Volume v. 13,, Issue no. 1

    Abstract: CASE: A 25-year-old woman with chronic anorexia nervosa and depression presented with sudden weakness and fatigue. Psychosocial history was notable for binge-starve cycles over the past year and a decline in overall well-being. Vitals on presentation ... ...

    Abstract CASE: A 25-year-old woman with chronic anorexia nervosa and depression presented with sudden weakness and fatigue. Psychosocial history was notable for binge-starve cycles over the past year and a decline in overall well-being. Vitals on presentation were notable for hypothermia, hypotension, and bradycardia. Initial exam was significant for emaciation, lethargy, and lower extremity edema. Laboratory work-up revealed markedly elevated LFTs, hypoglycemia, thrombocytopenia and elevated INR and lipase. ECG showed sinus bradycardia with prolonged QTc. Ultrasound revealed normal liver and biliary tree. Serum acetaminophen, alcohol level, and urinary toxicology were unremarkable. Work up for infectious, autoimmune, and genetic causes of hepatitis was negative. Echocardiogram revealed left ventricular hypokinesis and EF 10-15%. Nutritional support was begun slowly, however electrolyte derangements began to manifest on hospital day 2, with hypophosphatemia, hypokalemia, hypocalcemia, and hypomagnesemia. Multiple medical and psychiatric disciplines were consulted, and aggressive electrolyte monitoring and repletion were done. The patient’s overall clinical status improved slowly during her hospital course. Her liver enzymes trended down, and her QTc interval eventually returned toward the normal range. Repeat echocardiogram following treatment revealed improvement of her EF to 40%. DISCUSSION: Anorexia nervosa is an eating disorder characterized by extremely low body weight, fear of gaining weight or distorted perception of body image, and amenorrhea. Anorexia can lead to life threatening medical complications, and thus constitutes a major challenge to manage. Central to the pathogenesis of the refeeding syndrome is a weakened cardiopulmonary system, electrolytes abnormalities, hepatic dysfunction, liver hypoperfusion and failure. CONCLUSION: Given the clinical presentation, this patient likely presented on the brink of developing frank refeeding syndrome, with cardiac dysfunction and hypovolemia, leading to hepatic hypoperfusion and ischemic hepatitis. Subsequently, she developed electrolyte disturbances characteristic of refeeding syndrome, which were managed without major complication. Her hospital course is encouraging not only for her recovery, but for the collaboration of the different teams involved in her care, and it highlights the importance of a multidisciplinary approach to caring for patients with the potential dire complications of a complex psychiatric illness.
    Keywords blood serum ; amenorrhea ; biliary tract ; nutritional support ; hypocalcemia ; hypomagnesemia ; pathogenesis ; refeeding ; enzymes ; patients ; fearfulness ; anorexia nervosa ; alcohols ; ultrasonics ; emaciation ; hypokalemia ; heart ; monitoring ; gaining weight ; toxicology ; hypovolemic shock ; electrolytes ; hypothermia ; women ; teams ; repletion ; hypoglycemia ; thrombocytopenia ; edema ; body image ; anorexia ; acetaminophen ; hypotension ; liver ; hepatitis
    Language English
    Document type Article
    ISSN 1475-2891
    Database AGRIS - International Information System for the Agricultural Sciences and Technology

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