GI

How do you Manage the Adult with Perinatally Acquired Hepatitis B?

October 22, 2010
How do you Manage the Adult with Perinatally Acquired Hepatitis B?

Nathaniel Rosso Smilowitz, MD

Faculty Peer Reviewed

Hepatitis B virus is a DNA hepadnavirus affecting 1.25 million people in the United States and nearly 400 million worldwide.  The virus is transmitted perinatally, sexually, and percutaneously, and is endemic in many countries in South East Asia, Central Asia, and Africa.  When exposure occurs early in life, the likelihood of chronic infection is high; up to 90% of cases of vertical transmission result in the persistence of the viral envelope protein,…

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Does Heyde Syndrome (The Association Between Aortic Stenosis And Intestinal Angiodysplasia) Exist?

September 29, 2010
Does Heyde Syndrome (The Association Between Aortic Stenosis And Intestinal Angiodysplasia) Exist?

By Lara Dunn, MD

Faculty Peer Reviewed

In 1958, EC Heyde published 10 cases of aortic stenosis (AS) and arteriovenous malformations (AVMs) of the gastrointestinal tract in the New England Journal of Medicine .  Thus, the association between aortic stenosis and intestinal angiodysplasia became known as Heyde Syndrome.  Yet the existence of this syndrome has been controversial.

Contrasting conclusions have been obtained by studies conducted to evaluate this association.  In a prospective study, Bhutani and colleagues…

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The Role of Serologic Testing in the Diagnosis of Celiac Disease

August 18, 2010
The Role of Serologic Testing in the Diagnosis of Celiac Disease

By Todd Cutler

Faculty Peer Reviewed

A 31-year-old woman presents to the clinic with chronic fatigue. She was diagnosed with iron  deficiency anemia when she was 25 years old and has since taken oral contraceptives to limit bleeding during menstruation which she describes as minimal. She has a family history significant for an older brother with celiac disease. She is thin and her exam is significant for conjunctival pallor. Her laboratory findings are significant for a hemoglobin of 9.7

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Does Dietary Modification Help GERD?

June 18, 2010
Does Dietary Modification Help GERD?

By Ramya Srinivasan, MD

Faculty Peer Reviewed

The patient is a 29 year old overweight male presenting to clinic with complaints of reflux symptoms. He says that spicy foods aggravate these symptoms. In addition to weight loss counseling, he is given a prescription for esomeprazole along with a patient handout containing recommendations on foods to avoid and other behavior modifications that may ameliorate his symptoms.

Gastroesophageal reflux disease (GERD) is defined as the abnormal reflux of gastric contents into the…

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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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Myths and Realities: Ginger Ale in Treating Nausea and Vomiting

September 3, 2009
Myths and Realities:  Ginger Ale in Treating Nausea and Vomiting

Chau Che MD

Faculty peer reviewed

Despite the numerous medications available for the treatment of nausea and vomiting, some patients and doctors insist that ginger ale will alleviate gastrointestinal symptoms. As early as the first century AD, the Greek physician Dioscorides praised ginger root because it “gently stimulates the gut and is profitable for the stomach” (4). During the 16th century, the physician Lonicerus similarly wrote, “Ginger does good for a bad stomach” (4). Ginger has long medicinal roots…

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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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