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Comparison of reflux esophagitis and its complications between African Americans and non-Hispanic whites

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World journal of Gastroenterology 2009年第23期15卷 2878-2881页

作者： kenneth j vega Sian Chisholm M Mazen jamal Divisions of Gastroenterology and General Internal Medicine University of Florida Health Sciences Center Jacksonville Florida 32207 United States Gastroenterology Section Veterans Affairs Medical Center 5901 E. 7th St. Long Beach CA 90822 United States

AIM: To determine the effect of ethnicity on the severity of reflux esophagitis (RE) and its complications. METHODS: A retrospective search of the endoscopy database at the University of Florida Health Science Center/jacksonville for all cases of reflux esophagitis and its complications from january 1 to March 31, 2001 was performed. Inclusion criteria were endoscopic evidence of esophagitis using the LA classif ication, reflux related complications and self-reported ethnicity. The data obtained included esophagitis grade, presence of a hiatal hernia, esophageal ulcer, stricture and Barrett's esophagus, and endoscopy indication. RESULTS: The search identified 259 patients with RE or its complications, of which 171 were non-Hispanic whites and 88 were African Americans. The mean ages and male/female ratios were similar in the two groups. RE grade, esophageal ulcer, stricture and hiatal hernia frequency were likewise similar in the groups. Barrett's esophagus was present more often in non-Hispanic whites than in African Americans (15.8% vs 4.5%; P < 0.01). Heartburn was a more frequent indication for endoscopy in non-Hispanic whites with erosive esophagitis than in African Americans (28.1% vs 7.9%; P < 0.001). CONCLUSION: Distribution of RE grade and frequency of reflux-related esophageal ulcer, stricture andhiatal hernia are similar in non-Hispanic whites and African Americans. Heartburn was more frequently and nausea/vomiting less frequently reported as the primary endoscopic indication in non-Hispanic whites compared with African Americans with erosive esophagitis or its complications. African Americans have a decreased prevalence of Barrett's esophagus compared with non-Hispanic whites.

关键词：西班牙美国人并发症食管

Diabetes mellitus as a risk factor for gastrointestinal cancer among American veterans

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World journal of Gastroenterology 2009年第42期15卷 5274-5278页

作者： M Mazen jamal Eugene j Yoon kenneth j vega Mehrtash Hashemzadeh kenneth j Chang Division of Gastroenterology Veterans Affairs(VA) Medical CenterLong BeachCA 90822United States Division of Gastroenterology Department of Internal MedicineCollege of MedicineUniversity of CaliforniaIrvine Medical CenterOrangeCA 92868United States Division of Gastroenterology University of Florida/JacksonvilleJacksonvilleFL 32207United States

AIM:To assess the risk of biliary and pancreatic cancers in a large cohort of patients with type 2 diabetes mellitus(DM) .METHODS:Eligibility for this study included patients with type 2 DM(ICD-9 code 250.0) who were discharged from Department of Veteran Affairs hospitals between 1990 and ***-matched control patients without DM were selected from the same patient treatment files during the same *** information included age,sex and *** diagnoses included known risk factors based on their ICD-9 *** multivariate logistic regression,the occurrence of biliary and pancreatic cancer was compared between case subjects with DM and controls without ***:A total of 1172496 case and control subjects were *** mean age for study and control subjects was 65.8 ± 11.3 and 64.8 ± 12.6 years,*** frequency of pancreatic cancer in subjects with DM was increased(0.9%) in comparison to control subjects(0.3%) with an OR of 3.22(95% CI:3.03-3.42) .The incidence of gallbladder andextrahepatic biliary cancers was increased by twofold in diabetic patients when compared to *** OR and 95% CI were 2.20(1.56-3.00) and 2.10(1.61-2.53) ,***:Our study demonstrated that patients with DM have a threefold increased risk for developing pancreatic cancer and a twofold risk for developing biliary cancer.

关键词： 2型糖尿病退伍军人危险因素恶性肿瘤 logistic回归消化道风险因素美国

Disparities in esophageal cancer incidence and esophageal adenocarcinoma mortality in the United States over the last 25-40 years

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World journal of Gastrointestinal Endoscopy 2023年第12期15卷 715-724页

作者： Hafiz Muhammad Sharjeel Arshad Umer Farooq Ayesha Cheema Ayesha Arshad Muaaz Masood kenneth j vega Division of Gastroenterology&Hepatology Augusta University-Medical College of GeorgiaAugustaGA 30912United States Department of Internal Medicine Loyola Medicine/MacNeil HospitalBerwynIL 60402United States Department of Medicine Fatima Memorial Medical CollegeLahore 54000PunjabPakistan Department of Medicine Augusta University-Medical College of GeorgiaAugustaGA 30912United States

BACKGROUND Esophageal carcinoma presents as 2 types,esophageal adenocarcinoma(EAC)and esophageal squamous cell carcinoma(ESCC)with the frequency of both changing in the United States(US).AIM To investigate EAC/ESCC incidence time trends among the 3 main US racial groups and investigate trends in US EAC survival by *** Twenty-five years(1992-2016)of data from SEER 13 program was analyzed to compare incidence trends in EAC and ESCC between non-Hispanic whites(nHW),non-Hispanic Blacks(nHB)and Hispanics(Hisp)using SEERStat®.In addition,SEER 18 data,from 1975-2015,on EAC in the US was analyzed to evaluate racial disparities in incidence and survival using SEERStat®and Ederer II *** In the 3 major US ethnic groups,age-adjusted incidence of ESCC has declined while EAC has continued to rise from *** note,in Hisp,the EAC incidence rate increased while ESCC decreased from 1992 to 2016,resulting in EAC as the predominant esophageal cancer subtype in this group since 2011,joining ***,although ESCC remains the predominant tumor in nHB,the difference between ESCC and EAC has narrowed dramatically over 25 *** survival probabilities were worse in all minority groups compared to *** Hisp have joined nHW as US ethnic groups more likely to have EAC than *** note,EAC incidence in nHB is increasing at the highest rate *** lower EAC incidence in all minority groups compared to nHW,these populations have decreased survival compared to nHW.

关键词： Esophageal carcinoma Ethnicity Incidence Survival Disparity Race

Patient prompting of their physician resulted in increased colon cancer screening referrals

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World journal of Gastrointestinal Oncology 2014年第7期6卷 257-262页

作者： Vu Le Saqib Syed kenneth j vega Tushar Sharma Mohammad F Madhoun Nakumar Srinivasan Courtney W Houchen Division of Digestive Disease and Nutrition Univer-sity of Oklahoma Health Sciences Center Oklahoma City OK 73104 United States College of Public Health University of Okla-homa Health Sciences Center Oklahoma City OK 73104 United States

AIM:To determine whether a communication instru-ment provided to patients prior to their primary carephysician(PCP)visit initiates a conversation with theirPCP about colorectal cancer screening(CRC-S),impact-ing screening referral rates in fully insured and underin-sured ***:A prospective randomized control studywas performed at a single academic center outpatient internal medicine(IRMC,underinsured)and fam-ily medicine(FMRC,insured)resident clinics prior to scheduled *** the intervention group,a pamphlet about the benefit of CRC-S and a reminder card were given to patients before the scheduled visit for prompt-ing of CRC-S referral by their *** main outcome measured was frequency of CRC-S referral in each clinic after ***:In the IRMC,148 patients participated,a control group of 72 patients(40F and 32M)and 76 patients(48F and 28M)in the intervention ***-ferrals for CRC-S occurred in 45/72(63%)of control vs 70/76(92%)in the intervention group(P≤0.001).In the FMRC,126 patients participated,66(39F:27M)con-trol and 60(33F:27M)in the intervention ***-S referrals occurred in 47/66(71%)of controls vs 56/60(98%)in the intervention group(P≤0.001).CONCLUSION:Patient initiated physician prompting produced a significant referral increase for CRC-S in un-derinsured and insured patient *** investigation aimed at increasing CRC-S acceptance is warranted.

关键词：结肠癌屏蔽主要照顾医生耐心的关系工作分派

Retrograde jejunoduodenogastric intussusception due to a replacement percutaneous gastrostomy tube presenting as upper gastrointestinal bleeding

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World journal of Gastroenterology 2007年第39期13卷 5282-5284页

作者： Eric Ibegbu Manish Relan kenneth j vega Divisions of Gastroenterology and General Internal Medicine University of Florida Health Science Center/Jacksonville Jacksonville FL32207 United States

Percutaneous endoscopic gastrostomy (PEG) tube complications can be serious or life threatening. Retrograde intussusception is a very rare complication of PEG tubes with only 9 cases reported in the literature. We describe a case of retrograde intussusception, associated with the use of a Foley catheter as a replacement gastrostomy tube, presenting with upper gastrointestinal bleeding. To our knowledge, this is the first reported case of PEG-related retrograde intussusception successfully managed in a non-surgical manner. Retrograde intussusception likely occurred due to migration of the replacement tube with resultant securing and invagination of the proximal jejunum when the gastrostomy tube was anchored to the abdominal wall.

关键词：经皮内镜胃造瘘术肠套叠胃肠出血治疗方法

Artificial intelligence as a means to improve recognition of gastrointestinal angiodysplasia in video capsule endoscopy

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Artificial Intelligence in Gastrointestinal Endoscopy 2021年第4期2卷 179-184页

作者： Gerald A Cox II Christian S jackson kenneth j vega Department of Medicine Loma Linda University Medical CenterLoma LindaCA 92354United States Gastroenterology Section VA Loma Linda Healthcare SystemLoma LindaCA 92357United States Division of Gastroenterology and Hepatology Augusta University-Medical College of GeorgiaAugustaGA 30912United States

Gastrointestinal angiodysplasia(GIAD)is defined as the pathological process where blood vessels,typically venules and capillaries,become engorged,tortuous and thin walled–which then form arteriovenous connections within the mucosal and submucosal layers of the gastrointestinal *** are a significant cause of gastrointestinal bleeding and are the main cause for suspected small bowel *** make the diagnosis,gastroenterologists rely on the use of video capsule endoscopy(VCE)to“target”***,the use of VCE can be cumbersome secondary to reader fatigue,suboptimal preparation,and difficulty in distinguishing *** human eye is *** same capsule study read by two different readers are noted to have miss rates like other forms of *** intelligence(AI)has been a means to bridge the gap between human imperfection and recognition of *** use of AI in VCE have shown that detection has improved,however the other burdens and limitations still need to be *** use of AI for the diagnosis of GIAD shows promise and the changes needed to enhance the current practice of VCE are near.

关键词： Artificial intelligence Video capsule endoscopy Gastrointestinal angiodysplasia Detection Bleeding Small bowel

Intestinal stem cells and the colorectal cancer microenvironment

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World journal of Gastroenterology 2014年第8期20卷 1898-1909页

作者： Bryan A Ong kenneth j vega Courtney W Houchen Department of Digestive Diseases University of Oklahoma Health Sciences CenterOklahoma CityOK 73104United States

Colorectal cancer(CRC)remains a highly fatal condition in part due to its resilience to treatment and its propensity to spread beyond the site of primary *** possible avenue for cancer to escape eradication is via stem-like cancer cells that,through phenotypic heterogeneity,are more resilient than other tumor constituents and are key contributors to cancer growth and *** proliferative tumor cells are theorized to possess many properties akin to normal intestinal stem *** only do these CRC"stem"cells demonstrate similar restorative ability,they also share many cell pathways and surface markers in common,as well as respond to the same key niche *** the improvement of techniques for epithelial stem cell identification,our understanding of CRC behavior is also *** evidence about cellular plasticity and epithelial mesenchymal transition are shedding light onto metastatic CRC processes and are also challenging fundamental concepts about unidirectional epithelial *** review aims to reappraise evidence supporting the existence and behavior of CRC stem cells,their relationship to normal stem cells,and their possible dependence on the stem cell niche.

关键词： Colon cancer stem cells DCLK1 protein Stem cell ni

Neuroendocrine tumors of the gastrointestinal tract: Case reports and literature review

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World journal of Gastrointestinal Oncology 2014年第8期6卷 301-310页

作者： William j Salyers kenneth j vega juan Carlos Munoz Bruce W Trotman Silvio S Tanev Division of Gastroenterology University of Florida College of Medicine/Jacksonville Jacksonville FL 32207 United States Division of Digestive Diseases and Nutrition University of Oklahoma Health Sciences Center Oklahoma City OK 73104 United States Department of Medicine University of Maryland School of Medicine Baltimore MD 21201 United States Department of Pathology Manatee Memorial Hospital Bradenton FL 34208 United States

Neuroendocrine tumors(NET)previously called carcinoid tumors are neoplasms of enterochromaffin/neuroendocrine cell origin which display neurosecretory capacity that may result in the carcinoid *** annual incidence of patients with NET is 8.4 per 100000;yet many NET remain asymptomatic and clinically undetected.A majority of NET follows a benign course;however,some will display malignant *** most commonly occur in the gastrointestinal tract(67%)and bronchopulmonary system(25%).Gastrointestinal NET occur within the stomach,small intestine,liver,and *** report a retrospective study of 11 subjects:Eight with benign carcinoid tumors:duodenal bulb(n=2),terminal ileum(n=1),sigmoid colon(n=2),and rectum(n=3);three with malignant carcinoid:liver(n=1)and intra-abdominal site(n=2).The diagnosis,endoscopic images,outcome,treatment and review of the literature are presented.

关键词： Neuroendocrine Carcinoid Gastrointestinal Tumors

Gastrointestinal Kaposi's sarcoma: Case report and review of the literature

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World journal of Gastrointestinal Pharmacology and Therapeutics 2015年第3期6卷 89-95页

作者： Ann joo Lee Lacie Brenner Bashar Mourad Carmela Monteiro kenneth j vega juan Carlos Munoz Division of Gastroenterology Department of Medicine University of Florida College of Medicine Jacksonville Department of Medicine University of Florida College of Medicine Jacksonville Department of Pathology University of Florida College of Medicine Jacksonville Division of Digestive Diseases and Nutrition University of Oklahoma Health Sciences Center

Kaposi's sarcoma(KS) of the gastrointestinal tract is not an uncommon disease among individuals with acquired immunodeficiency syndrome(AIDS). The majority is asymptomatic, and for this reason, gastrointestinal KS(GI-KS) remains undiagnosed. With continued tumor growth, considerable variation in clinical presentation occurs including abdominal pain, nausea, vomiting, iron deficiency anemia(either chronic or frank gastrointestinal bleeding), and rarely mechanical obstruction alone or combined with bowel perforation. Endoscopy with biopsy allows for histological and immunohistochemical testing to confirm the diagnosis of GI-KS among those with clinical symptoms. In previous studies, dual treatment with highly active antiretroviral therapy and systemic chemotherapy have been associated with improved morbidity and mortality in individuals with visceral KS. Therefore, investigators have suggested performing screening endoscopies in select patients for early detection and treatment to improve outcome. In this review, we describe a 44 years old man with AIDS and cutaneous KS who presented for evaluation of postprandial abdominal pain, vomiting, and weight loss. On upper endoscopy, an extensive, infiltrative,circumferential, reddish mass involving the entire body and antrum of the stomach was seen. Histologic examination later revealed spindle cell proliferation, and confirmatory immunohistochemical testing revealed human herpes virus 8 latent nuclear antigen expression consistent with a diagnosis of gastric KS. Following this, we present a comprehensive review of literature on KS with emphasis on gastrointestinal tract involvement and management.

关键词： Kaposi sarcoma Acquired immunodeficiency syndrome Gastrointestinal endoscopy Epidemiology Gastrointestinal tumor symptoms