GI

Chief of Service Rounds: Should You Always Stop Anticoagulating a Bleeding Patient?

January 20, 2010
Chief of Service Rounds: Should You Always Stop Anticoagulating a Bleeding Patient?

Chief-of-service rounds is a new feature of Clinical Correlations.  Here we summarize Bellevue Hospital’s Chief of Service Rounds moderated by the Chief of Medicine, Nate Link, MD.  This multidisciplinary bimonthly conference focuses on a case that presents a diagnostic or treatment challenge.  A clinical question is posed at the end of the case and then answered using the principles of evidence based medicine.

Daria Crittenden , MD

Moderator: Nate Link, MD Associate Professor of Medicine, . GI consultant:  Gerry Villanueva, MD Clinical Assistant Professor of Medicine…

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Tailoring Colon Cancer Screening

December 19, 2009
Tailoring Colon Cancer Screening

Guidelines for Colorectal Cancer Screening and the Recent Evidence Behind Them

 Nazia Hasan, MD MPH

Faculty peer reviewed

For most residents, screening for colorectal cancer (CRC) may seem as established as that for breast and cervical cancer. In reality, the use of CRC screening has only recently approached that of screening for those other malignancies. We have seen recently changes to the CRC screening guidelines last published by The American College of Gastroenterology in 2000. The updated screening guidelines for colorectal cancer became available…

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Tailoring Colon Cancer Screening

December 11, 2009
Tailoring Colon Cancer Screening

Guidelines for Colorectal Cancer Screening and the Recent Evidence Behind Them

 Nazia Hasan, MD MPH

Faculty peer reviewed

For most residents, screening for colorectal cancer (CRC) may seem as established as that for breast and cervical cancer. In reality, the use of CRC screening has only recently approached that of screening for those other malignancies. We have seen recently changes to the CRC screening guidelines last published by The American College of Gastroenterology in 2000.…

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Tailoring Colon Cancer Screening

October 29, 2009
Tailoring Colon Cancer Screening

Guidelines for Colorectal Cancer Screening and the Recent Evidence Behind Them

 Nazia Hasan, MD MPH

Faculty peer reviewed

For most residents, screening for colorectal cancer (CRC) may seem as established as that for breast and cervical cancer. In reality, the use of CRC screening has only recently approached that of screening for those other malignancies. We have seen recently changes to the CRC screening guidelines last published by The American College of Gastroenterology in 2000.…

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Can you offer a liver transplant to a patient with HIV?

August 28, 2009
Can you offer a liver transplant to a patient with HIV?

Faculty Peer Reviewed

Uzma Sarwar MD

Coincident with greater use of highly active antiretroviral therapy (HAART), chronic liver disease has become one of the leading causes of death amongst HIV patients. This reflects the high prevalence of chronic liver diseases in the HIV-infected; almost a third of HIV-seropositive patients are afflicted with liver disease, predominantly as a result of hepatitis B and/or hepatitis C co-infection. Given their increased life-span, many HIV-infected patients now progress to end-stage liver disease, where…

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CT Colonography-The Future of Colorectal Cancer Screening?

August 21, 2009
CT Colonography-The Future of Colorectal Cancer Screening?

Ely R. Felker


Faculty Peer Reviewed

The patient is a 52 year-old white male who presented to his internist for a routine examination. He has no family history of colorectal cancer. He has not previously been screened. He recently heard about CT colonography and would like to know how it compares to conventional colonoscopy. Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer death…

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The Asian Glow: A unique screening tool to evaluate for an elevated risk of esophageal cancer

July 29, 2009
The Asian Glow: A unique screening tool to evaluate for an elevated risk of esophageal cancer

Cindy Mui MD

Faculty Peer Reviewed

The alcohol flushing response is a physiologic response to ingestion of alcohol and is characterized by facial flushing, nausea, tachycardia, and hypotension, felt to be due to an inherited deficiency in the enzyme aldehyde dehydrogenase 2 (ALDH2). It is experienced by one third of East Asians and is more commonly known as the “Asian glow” or the “Asian flush”(1). Although the alcohol flushing response is generally seen as cosmetic and even embarrassing on…

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Myths and Realities: Colon Cleansing: Healthful or just a load of @$%!

July 16, 2009
Myths and Realities: Colon Cleansing: Healthful or just a load of @$%!

Chau Che MD

Faculty Peer Reviewed

You’ll have increased energy, radiant skin, reduced joint pain, improved asthma symptoms, and best of all…you will lose weight. These are some of the purported benefits of removing “toxins” (otherwise known as undigested material) from the colon through cleansing. As with fashion, music, and art, what’s old has a way of becoming trendy again…especially when celebrities such as Beyonce talk about it on the Oprah Winfrey show. Colon cleansing has become popular but it…

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How Should You Approach a Patient Co-infected with HIV and Hepatitis C?

June 11, 2009
How Should You Approach a Patient Co-infected with HIV and Hepatitis C?

Uzma Sarwar MD

Faculty Peer Reviewed

With advancement in therapy, life expectancy has significantly increased among HIV-infected patients, and patients are now more likely to succumb to chronic disease processes. At present, approximately one third of deaths in HIV patients are related to liver disease, which has become the leading cause of death amongst HIV patients. The risk of death from liver disease in HIV patients is inversely related to their CD4 count. Infection with hepatitis C virus (HCV) accounts…

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Should we treat asymptomatic autoimmune hepatitis?

April 30, 2009
Should we treat asymptomatic autoimmune hepatitis?

Bani Chander MD

Faculty Peer Reviewed

Autoimmune hepatitis (AIH) is a progressive, inflammatory disease of the liver of unknown etiology and may progress to cirrhosis. While it is does have a predilection for women, this disease entity crosses genders and ethnic groups, and may occur in both adults and children. AIH is characterized by a fluctuating course and is often associated with autoimmune features including hypergammaglobulinemia, circulating serum autoantibodies, and hepatitis with lymphoplasmacytic infiltration on liver biopsy . Autoimmune…

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Morning Report: Hepatorenal Syndrome

February 19, 2009
Morning Report: Hepatorenal Syndrome

Commentary by Catherine Lucero MD, PGY-3

Faculty Peer Reviewed

The patient is a 69-year old woman from El Salvador with a chief complaint of worsening abdominal distension for nine months. Three months earlier, the patient was told she had liver problems and was started on diuretics. Prior to presentation, the patient states that she stopped taking her medication and noticed increasing lower extremity edema and abdominal girth, as well as an unintentional 15-pound weight loss. The patient denied any other medical problems, including fever, chills,…

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Analgesia for Cirrhotics: A Practical Approach

November 20, 2008
Analgesia for Cirrhotics:  A Practical Approach

Commentary by Albert B. Knapp MD, NYU Clinical Professor of Medicine (Gastroenterology)

THE CASE:
WS, a 49 yo year old Caucasian male with a known 35 year history of alcohol abuse, now presents with jaundice, tense ascites and a left shoulder fracture following a bar room brawl last night. He is admitted to the orthopedic service for elective pinning but is presently in great pain. You are consulted in regards to pain management….

THE QUESTION:
How should you approach…

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