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Colorectal cancer screening in human immunodeficiency virus population:Are they at average risk?

World Journal of Gastrointestinal Oncology 2012年第12期4卷 259-264页

作者： suresh Kumar nayudu Bhavna Balar Division of Gastroenterology Department of MedicineBronx Lebanon Hospital CenterAffiliated with Albert Einstein College of MedicineYeshiva University

AIM:To evaluate if human immunodeficiency virus (HIV) population is getting adequate screening for colon cancer in the highly active anti-retroviral treatment (HAART) era with improved longevity, and the prevalence of polyps and adenomas in this population, when compared with the general population. METHODS:We conducted retrospective chart review of average-risk HIV population for colon cancer attending our infectious disease clinic. Individuals who underwent diagnostic colonoscopy were excluded. We extracted various demographic, HIV disease-specific and colonoscopy data including histo-pathological reports in the last 10 years. Total population was divided into a study group, who underwent screening colonoscopy and a control group who did not. We analyzed data using standard statistical methods and software. RESULTS:We found that 25% of average-risk HIVinfected population was screened for colon cancer using colonoscopy. There was no difference in gender and ethnic distribution between the groups. We foundwider distribution of age (50-84 years with mean 56 years) in the control group when compared to (50-73 years with mean 58 years) the study group. However, there were 89% of subjects with well-controlled HIV disease measured by HIV RNA copies of < 75 in the study group when compared with 70% in the control group (P < 0.0001). We noticed polyp detection rate of 55% and adenoma detection rate of 32% in HIV population. CONCLUSION:It is unclear whether HIV or HAART medications play a role in increased prevalence of adenomas. We suggest that when estimating the risk for colonic neoplasms, HIV population should be considered as a high-risk group and screened accordingly.

关键词： Colorectal cancer Screening Human immunodeficiency virus Highly active anti-retroviral treatment

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Predictors of acute gastrointestinal bleeding in diabetic ketoacidosis:a retrospective observational study in minority population

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Gastroenterology Report 2017年第4期5卷 293-297,I0002页

作者： Kanthi Rekha Badipatla Preeti Jadhav Sushma Vaddigiri Bharat Bajantri Amandeep Singh Chaitanya Chandrala Vijay S Are suresh Kumar nayudu Department of Medicine Bronx Lebanon Hospital CenterIcahn School of Medicine at Mount SinaiBronxNew YorkNYUSA Division of Gastroenterology Bronx Lebanon Hospital CenterIcahn School of Medicine at Mount SinaiBronxNew YorkNYUSA Division of Pulmonary and Critical Care Bronx Lebanon Hospital CenterIcahn School of Medicine at Mount SinaiBronxNew YorkNYUSA Division of Cardiology Bronx Lebanon Hospital CenterIcahn School of Medicine at Mount SinaiBronxNew YorkNYUSA

Background:Diabetic ketoacidosis(DKA)is a common acute complication of diabetes mellitus requiring aggressive medical *** attempted to study the incidence and various clinical and laboratory variables associated with acute gastrointestinal bleeding(AGIB)and acute upper AGIB(AUGIB)in patients with ***:We conducted a retrospective chart review of all the patients admitted to our hospital with DKA between January 2010 and December *** collected demographic,clinical,laboratory,endoscopy and hospitalization details using an electronicmedical-record *** were divided into two groups based on the occurrence of gastrointestinal ***:A total of 234 patients with DKA were admitted during this period,of which 27(11.5%)patients had documented *** majority of patients had hematemesis(n=22,9.4%)except two had rectal and three had occult *** did not notice any difference in age,gender and ethnicity distribution between the two *** was no difference in the serum levels of electrolytes,anion gap,pH and hemoglobin A1C between the two ***,patients with AGIB had significantly higher initial blood glucose levels(738 vs 613 mg/dL,p=0.014).There was also increased mortality(7.4%vs 4.8%)in patients with AGIB,but this did not reach statistical ***:We conclude that higher initial serum blood glucose was associated with increased incidence of AGIB in patients admitted with *** also noted increased in-patient mortality in patients with DKA who had AGIB,even though statistically *** aggressive measures to correct blood glucose levels may result in decreased incidence of AGIB,thereby reducing mortality during hospitalization in patients with DKA.

关键词： diabetic ketoacidosis gastrointestinal bleeding mortality

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Prevalence of advanced liver fibrosis and steatosis in type-2 diabetics with normal transaminases:A prospective cohort study

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World Journal of Gastroenterology 2021年第6期27卷 523-533页

作者： Jasbir Makker Hassan Tariq Kishore Kumar Madhavi Ravi Danial Haris Shaikh Vivien Leung Umar Hayat Muhammad T Hassan Harish Patel suresh nayudu Sridhar Chilimuri Division of Gastroenterology Department of MedicineBronxCare Health SystemBronxNY 10457United States KU School of Medicine-Wichita University of KansasWichitaKS 67214United States Department of Medicine BronxCare Health SystemBronxNY 10457United States

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)and type-2 diabetes mellitus(T2DM)have an intricate bidirectional *** with T2DM,not only have a higher prevalence of non-alcoholic steatosis,but also carry a higher risk of progression to nonalcoholic *** still differ in their recommendations of screening for NAFLD among patients with *** To study the prevalence of NAFLD and advanced fibrosis among our patient population with *** During the study period(November 2018 to January 2020),59 adult patients with T2DM and 26 non-diabetic control group individuals were recruited *** with known significant liver disease and alcohol use were *** data and lab parameters were *** elastography was performed in all *** In the study group comprised of patients with T2DM and normal alanine aminotransferase levels(mean 17.8±7 U/L),81%had hepatic steatosis as diagnosed by *** hepatic fibrosis(stage F3 or F4)was present in 12%of patients with T2DM as compared to none in the control *** with T2DM also had higher number of individuals with grade 3 steatosis[45.8%vs 11.5%,(P<0.00001)and metabolic syndrome(84.7%vs 11.5%,P<0.00001)].CONCLUSION A significant number of patients with T2DM,despite having normal transaminase levels,have NAFLD,grade 3 steatosis and advanced hepatic fibrosis as measured by liver elastography.

关键词： Advanced liver fibrosis Diabetes Steatosis Normal transaminases Fatty liver disease Metabolic syndrome

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Patients with Clostridium difficile infection and prior appendectomy may be prone to worse outcomes

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World Journal of Gastrointestinal Surgery 2021年第11期13卷 1436-1447页

作者： Danial Haris Shaikh Harish Patel Rezwan Munshi Haozhe Sun Shehriyar Mehershahi Ahmed Baiomi Ahmed Alemam Usman Pirzada Iqra Nawaz Kamrun Naher Siddarth Hanumanthu suresh nayudu Division of Gastroenterology Department of MedicineBronxCare Health SystemBronxNY 10457United States Department of Medicine Nassau University Medical CenterNew YorkNY 11554United States Department of Medicine BronxCare Health SystemBronxNY 10457United States

BACKGROUND Clostridium difficile infection(CDI)occurs due to a dysbiosis in the *** appendix is considered a‘safe house’for gut microbiota and may help repopulate gut flora of patients with *** To study the impact of prior appendectomy on the severity and outcomes of *** We retrospectively reviewed data of 1580 patients with CDI,admitted to our hospital between 2008 to *** were grouped based on the presence or absence of the *** primary aim was to(1)assess all-cause mortality and(2)the severity of *** was defined as per the Infectious Diseases Society of America *** regression,and propensity score analysis using inverse probability of treatment weights(IPTW)was *** Of the 1580 patients,12.5%had a history of *** was no statistical difference in mortality between patients with a prior appendectomy or without(13.7%vs 14%,P=0.877).However,a history of appendectomy affected the severity of CDI[odds ratio(OR)=1.32,95%confidence interval:1.01-1.75].On IPTW,this association remained significant(OR=1.59,P<0.05).On multivariable toxic megacolon(OR=5.37,P<0.05)and colectomy(OR=2.77,P<0.05).CONCLUSION Prior appendectomy may affect the severity of CDI,development of toxic megacolon and the eventual need for *** treatment of CDI is governed by its severity,stronger antibiotic regimens or earlier use of fecal microbiota transplant may be a viable option for patients with prior appendectomy.

关键词： Appendectomy Clostridium difficile Toxic megacolon Colectomy Gut microbiome

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