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Takotsubo Cardiomyopathy Triggered by Acute Pancreatitis: A Case Report

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Case Reports in Clinical medicine 2024年第4期13卷 87-94页

作者： Ketevan Kapanadze Elene Shengelia Keti Solomnishvili Ahmed Saleh Abdelkader Maha Kassem internal medicine and Intensive Therapy Department Tbilisi Central Hospital Tbilisi Georgia internal medicine residency program Tbilisi State Medical University Tbilisi Georgia School of medicine New Vision University Tbilisi Georgia

Takotsubo cardiomyopathy is a heart condition that is widely known to be caused by stress. It presents with symptoms that are similar to a myocardial infarction even though the coronary arteries are clear. This case report details the clinical characteristics, diagnostic assessment, and management plan of a 55-year-old male patient with a past medical history of alcoholism who arrived at the emergency department with the typical symptoms of acute pancreatitis. The case demonstrates the progression of Takotsubo cardiomyopathy, which was triggered by acute pancreatitis in the context of alcoholism, and underlines the significance of early detection and management to enhance the patient’s outcomes.

关键词： Takotsubo Cardiomyopathy Acute Pancreatitis Alcoholism Epigastric Pain

Diagnostic Dilemma of Intracardiac Mass: Tumor versus Thrombus-Case Series and Systematic Review

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Journal of Biosciences and medicines 2024年第7期12卷 141-150页

作者： Indira Acharya Ashik Pokharel Raktim Ghosh Christopher J. Haas Department of internal medicine Internal Medicine Residency Program Medstar Health Baltimore MD USA Department of Cardiology MedStar Union Memorial Hospital MedStar Health Baltimore MD USA School of medicine Georgetown University Washington D.C. USA

Background: The differential diagnosis for intracavitary cardiac masses is limited, typically including vegetations, tumors, or thrombi. Cardiac thrombi can often mimic cardiac tumors on imaging, creating a diagnostic challenge. Primary cardiac tumors are rare and usually benign, whereas most cardiac tumors result from metastases, commonly originating from malignancies in the breast, lung, or melanoma. Aim: This report highlights the importance of distinguishing various cardiac masses based on clinical presentations, clinical courses, and radiological features. Case Presentation: We describe two cases of cardiac masses with unique and diverse clinical features. Each case posed significant diagnostic challenges due to their distinct presentations and clinical progressions. Conclusion: These cases underscore the importance of considering both benign and metastatic origins in the differential diagnosis of intracavitary cardiac masses. Accurate differentiation between thrombi and tumors is crucial for appropriate management and treatment.

关键词： Echocardiography Cardiac Masses Arrhythmias Cardiac Magnetic Resonance Imaging Cardiac Thrombi

Machine learning models compared to existing criteria for noninvasive prediction of endoscopic retrograde cholangiopancreatography-confirmed choledocholithiasis

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Liver Research 2021年第4期5卷 224-231页

作者： Camellia Dalai John M Azizian Harry Trieu Anand Rajan Formosa C Chen Tien Dong Simon W Beaven James H.Tabibian ucla-olive view internal medicine residency program Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA Keck School of medicine University of Southern CaliforniaLos AngelesCAUSA Department of Surgery David Geffen School of Medicine at UCLALos AngelesCAUSA Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at UCLALos AngelesCAUSA Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA

Background and aims:Noninvasive predictors of choledocholithiasis have generally exhibited marginal performance *** aimed to identify noninvasive independent predictors of endoscopic retrograde cholangiopancreatography(ERCP)-confirmed choledocholithiasis and accordingly developed predictive machine learning models(MLMs).Methods:Clinical data of consecutive patients undergoing first-ever ERCP for suspected chol-edocholithiasis from 2015 to 2019 were abstracted from a prospectively-maintained *** logistic regression was used to identify predictors of ERCP-confirmed *** were then trained to predict ERCP-confirmed choledocholithiasis using pre-ERCP ultrasound(US)imaging only as well as using all available noninvasive imaging(US,computed tomography,and/or magnetic reso-nance cholangiopancreatography).The diagnostic performance of American Society for Gastrointestinal Endoscopy(ASGE)“high-likelihood”criteria was compared to ***:We identified 270 patients(mean age 46 years,62.2%female,73.7%Hispanic/Latino,59%with noninvasive imaging positive for choledocholithiasis)with native papilla who underwent ERCP for suspected choledocholithiasis,of whom 230(85.2%)were found to have ERCP-confirmed *** regression identified choledocholithiasis on noninvasive imaging(odds ratio(OR)¼3.045,P¼0.004)and common bile duct(CBD)diameter on noninvasive imaging(OR¼1.157,P¼0.011)as predictors of ERCP-confirmed *** the various MLMs trained,the random forest-based MLM performed best;sensitivity was 61.4%and 77.3%and specificity was 100%and 75.0%,using US-only and using all available imaging,*** high-likelihood criteria demonstrated sensitivity of 90.9%and specificity of 25.0%;using cut-points achieving this specificity,MLMs achieved sensitivity up to 97.7%.Conclusions:MLMs using age,sex,race/ethnicity,presence of diabetes,fever,body mass index(BMI),total bilirubin,maximum CBD di

关键词： Machine learning models(MLMs) Endoscopic retrograde cholangiopancreatography(ERCP) Noninvasive imaging Bile duct disorders Common bile duct stones Gallstones

Biliary endoscopy in the management of primary sclerosing cholangitis and its complications

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Liver Research 2019年第2期3卷 106-117页

作者： Brian M.Fung James H.Tabibian University of California Los Angeles-olive view internal medicine residency program SylmarCAUSA Division of Gastroenterology Department of MedicineOlive View-University of California Los Angeles Medical CenterSylmarCAUSA

Primary sclerosing cholangitis(PSC)is a chronic,idiopathic,cholestatic liver disease characterized by inflammation and fibrosis of the intrahepatic and/or extrahepatic bile *** can affect individuals of all age groups and gender,has no established pharmacotherapy,and is associated with a variety of neoplastic(***)and non-neoplastic(*** strictures)hepatobiliary *** these considerations,endoscopy plays a major role in the care of patients with *** this review,we discuss and provide updates regarding endoscopic considerations in the management of hepatobiliary manifestations and complications of *** evidence is limited,we suggest pragmatic approaches based on currently available data and expert opinion.

关键词： Primary sclerosing cholangitis(PSC) Biliary tract disease Balloon dilation Cholangioscopy Dominant stricture Cholangiocarcinoma(CCA) Endoscopic retrograde cholangiopancreatography(ERCP)

Foreign object ingestion and esophageal food impaction:An update and review on endoscopic management

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World Journal of Gastrointestinal Endoscopy 2019年第3期11卷 174-192页

作者： Brian M Fung Seth Sweetser Louis M Wong Kee Song James H Tabibian ucla-olive view internal medicine residency program Division of Gastroenterology and Hepatology Mayo Clinic Division of Gastroenterology Olive View-UCLA Medical Center

Foreign body ingestion encompasses both foreign object ingestion(FOI) and esophageal food impaction(EFI) and represents a common and clinically significant scenario among patients of all ages. The immediate risk to the patient ranges from negligible to life-threatening, depending on the ingested substance,its location, patient fitness, and time to appropriate therapy. This article reviews the FOI and EFI literature and highlights important considerations and implications for pediatric and adult patients as well as their providers. Where published literature is insufficient to provide evidence-based guidance, expert opinion is included to supplement the content of this comprehensive review.

关键词： Foreign bodies Endoscopy Gastrointestinal emergency Medical management Dysphagia

Ileal inflammatory fibroid polyp causing chronic ileocolic intussusception and mimicking cecal carcinoma

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World Journal of Gastrointestinal Oncology 2009年第1期1卷 89-92页

作者： Naveen Gara John S Falzarano Whitney ML Limm Thomas S Namiki Laurie KS Tom Uinversity of Hawaii internal medicine residency program

Inflammatory fibroid polyp(IFP) is a rare,idiopathic pseudotumorous lesion of the gastrointestinal *** mostly reported as solitary gastric lesions,multiple cases of small bowel IFPs are also *** is a documented cause of intussusception in *** the case reports of ileal inflammatory fibroid polyps with intussusception,an emergent presentation with small bowel obstruction has been most often *** we depict a case of ileal inflammatory fibroid polyp presenting with chronic intermittent ileocolic intussusception,anemia and weight loss with an endoscopic appearance mimicking necrotic cecal carcinoma.

关键词： Ileal polyp Colon cancer Endoscopy Intussusception Intussusception in elderly

Hepatocellular carcinoma surveillance:An evidence-based approach

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World Journal of Gastroenterology 2019年第13期25卷 1550-1559页

作者： Patrick S Harris Ross M Hansen Meagan E Gray Omar I Massoud Brendan M McGuire Mohamed G Shoreibah Tinsley Harrison internal medicine residency program Department of Medicine University of Alabama at Birmingham Division of Gastroenterology and Hepatology Department of Medicine University of Alabama at Birmingham

Hepatocellular carcinoma(HCC) makes up 75%-85% of all primary liver cancers and is the fourth most common cause of cancer related death worldwide. Chronic liver disease is the most significant risk factor for HCC with 80%-90% of new cases occurring in the background of cirrhosis. Studies have shown that early diagnosis of HCC through surveillance programs improve prognosis and availability of curative therapies. All patients with cirrhosis and high-risk hepatitis B patients are at risk for HCC and should undergo surveillance. The recommended surveillance modality is abdominal ultrasound(US) given that it is cost effective and noninvasive with good sensitivity. However, US is limited in obese patients and those with non-alcoholic fatty liver disease(NAFLD). With the current obesity epidemic and rise in the prevalence of NAFLD, abdominal computed tomography or magnetic resonance imaging may be indicated as the primary screening modality in these patients. The addition of alpha-fetoprotein to a surveillance regimen is thought to improve the sensitivity of HCC *** investigation of serum biomarkers is needed. Semiannual screening is the suggested surveillance interval. Surveillance for HCC is underutilized and low adherence disproportionately affects certain demographics such as nonCaucasian race and low socioeconomic status.

关键词： Liver cancer Hepatocellular carcinoma Surveillance

Hemobilia: Etiology, diagnosis, and treatment

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Liver Research 2018年第4期2卷 200-208页

作者： Rani Berry James Han Ani A.Kardashian Nicholas F.LaRusso James H.Tabibian Department of internal medicine UCLA Ronald Reagan Medical CenterLos AngelesCAUSA Department of internal medicine University of California IrvineIrvineCAUSA ucla Gastroenterology Fellowship Training program Vatche and Tamar ManoukianDivision of Digestive DiseasesLos AngelesCAUSA Division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA

Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon but important cause of gastrointestinal *** of hemobilia date back to the 1600s,but due to its relative rarity and challenges in diagnosis,only in recent decades has hemobilia been more critically *** majority of cases of hemobilia are iatrogenic and caused by invasive procedures involving the liver,pancreas,bile ducts and/or the hepatopancreatobiliary vasculature,with trauma and malignancy rep-resenting the two other leading causes.A classic triad of right upper quadrant pain,jaundice,and overt upper gastrointestinal bleeding has been described(***'s triad),but this is present in only 25%e30%of patients with ***,prompt diagnosis depends critically on having a high index of suspicion,which may be based on a patient's clinical presentation and having recently undergone(peri-)biliary instrumentation or other predisposing *** treatment of hemobilia depends on its severity and suspected source and ranges from supportive care to advanced endoscopic,interventional radiologic,or surgical *** we provide a clinical overview and update regarding the eti-ology,diagnosis,and treatment of hemobilia geared for specialists and subspecialists alike.

关键词： Hemobilia Upper gastrointestinal hemmorhage Etiology Diagnosis Imaging Hepatopancreatobiliary interventions

Clinical outcomes in patients diagnosed with extra-nodal Hodgkin lymphoma: a 20-year retrospective analysis of the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database

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Cancer Advances 2024年第13期7卷 1-6页

作者： Kingsley Nnawuba Anup Kumar Trikannad Ashwini Kumar Sruthi Vellanki Tochukwu Nzeako Samantha Robinson Hanna Jensen internal medicine residency program University of Arkansas for Medical Sciences-Northwest Regional Campus1125 North College AvenueFayettevilleArkansas 72703USA Division of Hematology Oncology and Myeloma University of Arkansas for Medical Sciences449 Jack Stephens Drive UAMS Winthrop P.Rockefeller Cancer Institute Seventh Floor Little RockArkansas 72205USA internal medicine Department Christiana Care Hospital4755 Ogletown Stanton RdNewarkDelaware 19718USA School of Human Environmental Sciences University of ArkansasRoom 118Home Economics Building987 W Maple StFayetteville AR 72701USA Department of Surgery University of Arkansas for Medical SciencesNorthwest Regional Campus1125 North College AvenueFayettevilleArkansas 72703USA.

Background:Hodgkin lymphoma refers to a malignancy of the lymphatic ***-nodal Hodgkin lymphoma(ENHL)is a rare variant consisting of Hodgkin lymphoma occurring outside the lymphatic *** investigating the epidemiology associated with ENHL are ***:618 ENHL cases were analyzed using the National Cancer Institute’s Surveillance,Epidemiology,and End Results(SEER)database(2000–2020).Demographics including sex,race/ethnicity,rural-urban continuum,age group(categorized as adolescent and young adult(AYA)if between years of 15 and 39,and adult if over the age of 40),and living status(alive/deceased)were examined,with survival status as the main ***:This study included 335 males(54.2%)and 283 females(45.8%).Of this total,47.9%were in the AYA *** terms of ethnicity the distribution was 12.5%non-Hispanic Black,67.5%non-Hispanic White,5.2%non-Hispanic Asian/Pacific Islander,and 14.9%*** analyses evidenced significant differences in survival by age group with 91.6%in AYA vs.72.4%in adults(P<0.001)alive by the end of the study *** analyses identified age as a key predictor of survival,as the AYA patients had a lower odds ratio for death(odds ratio=0.25,P<0.001).In addition,survival outcomes were also impacted by race,with non-Hispanic Blacks showing higher survival *** treatment,27.0%of patients underwent surgery,with 10.2%receiving post-surgery radiation,reducing odds of mortality(odds ratio=0.32,P=0.046).Conclusion:The background research as such,tends to affirm that these two factors–age and race are quite crucial in the prognosis as well as management of *** to adults,AYA patients had significantly lower odds of death,while non-Hispanic Black individuals exhibited reduced survival *** should be noted that 27.0%of patients underwent surgery with 10.2%receiving post-operative radiation which led to decrease in mortality ***,these results reiterate the nec

关键词： Hodgkin lymphoma extra nodal disease SEER cancer survival