Physician Education Resources

The Orlando Health Digestive Health Institute serves as an educational center of excellence for physicians around the globe. We focus on academics and scholarship, staying on the forefront of advancements and sharing our knowledge. The integration of advanced audiovisual technology allows us to offer live transmission of procedures to a global physician audience along with high-quality, video-based educational materials. Our physicians offer a monthly journal club centered around synopses of topical offerings from select studies. Our physicians offer a monthly journal club centered around synopses of topical offerings from select studies, as well as open access journal articles from PubMed.

Single-use Duodenoscope:Where are we now and where are we going?

We are pleased to present a State-of-the-Art update on single-use duodenoscope technology. We hope that this presentation will be of relevance to your clinical practice. Ji Young Bang, MD, MPH Shyam Varadarajulu, MD

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Author(s) Title Description Publish Date
Eun-Hye Joo, Jai Hee Bae, Jihye Park, Yoon Ji Bang, Joseph Han, Nicholas Gulati, Jong-Il Kim, Chung-Gyu Park, Woong-Yang Park, Hyun Je Kim Deconvolution of Adult T-Cell Leukemia/Lymphoma With Single-Cell RNA-Seq Using Frozen Archived Skin Tissue Reveals New Subset of Cancer-Associated Fibroblast Adult T-cell Leukemia/Lymphoma (ATLL) is a rare aggressive T-cell malignancy caused by human T-cell leukemia virus type 1 (HTLV-1) infection. However, little is known about the underlying activated molecular pathways at the single cell level. Moreover, the intercellular communications between the tu... 4/25/2022
Shivanand Bomman, Adil Ghafoor, David J Sanders, Mahendran Jayaraj, Shruti Chandra, Rajesh Krishnamoorthi Endoscopic ultrasound-guided gastroenterostomy versus surgical gastrojejunostomy in treatment of malignant gastric outlet obstruction: Systematic review and meta-analysis Background and study aims Palliative treatment of malignant gastric outlet obstruction (GOO) has conventionally been with surgical gastrojejunostomy (SGJ). Advent of devices like lumen apposing metal stents has made endoscopic ultrasound-guided gastroenterostomy (EUS-GE) a potential alternative to ... 4/18/2022
Martin Faye, Thiané Seye, Pranav Patel, Cheikh Tidiane Diagne, Moussa Moise Diagne, Moussa Dia, Fatou Diène Thiaw, Amadou Alpha Sall, Ousmane Faye Development of Real-Time Molecular Assays for the Detection of Wesselsbron Virus in Africa Wesselsbron is a neglected, mosquito-borne zoonotic disease endemic to Africa. The virus is mainly transmitted by the mosquitoes of the Aedes genus and primarily affects domestic livestock species with teratogenic effects but can jump to humans. Although no major outbreak or fatal case in humans has... 3/26/2022
Shivanand Bomman, Munish Ashat, Navroop Nagra, Mahendran Jayaraj, Shruti Chandra, Richard A Kozarek, Andrew Ross, Rajesh Krishnamoorthi Contamination Rates in Duodenoscopes Reprocessed Using Enhanced Surveillance and Reprocessing Techniques: A Systematic Review and Meta-Analysis CONCLUSION: While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoing efforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design to improve safety are warranted. 1/3/2022
Shannon K Brewer, Pranav Patel, Riad Kesiry An Unusual Case of Obstructive Jaundice Secondary to Pyogenic Liver Abscesses Pyogenic liver abscesses (PLA) are an uncommon, but potentially life-threatening infection. Although the link between amebic liver abscesses and obstructive jaundice is well documented, there are few cases of PLA leading to this complication. We present a case of multiple massive PLA and obstructive... 8/19/2021
Pranav Patel, Aaron Lee, Jordan Zaid, John Tenuto, Brett Waldman, Michael Rosenbloom, James Kovacs, Loheetha Ragupathi Inferior Vena Cava Obstruction Following Surgical Repair of a Secundum Atrial Septal Defect Obstruction of the inferior vena cava (IVC) following surgical repair of an atrial septal defect (ASD) is a rare complication. We present the case of a patient who developed IVC obstruction following surgical repair of a large secundum ASD. The diagnostic and management approaches used to care for t... 7/28/2021
Pietro Fusaroli, Mohamad Eloubeidi, Claudio Calvanese, Christoph Dietrich, Christian Jenssen, Adrian Saftoiu, Claudio De Angelis, Shyam Varadarajulu, Bertrand Napoleon, Andrea Lisotti, QUOREUS study group Quality of reporting in endoscopic ultrasound: Results of an international multicenter survey (the QUOREUS study) Background and study aims The endoscopic report has a key role in quality improvement for gastrointestinal endoscopy. High quality standards have been set by the endoscopic societies in this field. Unlike other digestive endoscopy procedures, the quality of reporting in endoscopic ultrasound (EUS) ... 7/5/2021
Adam Penn-Nicholson, Sivaramakrishnan N Gomathi, Cesar Ugarte-Gil, Abyot Meaza, Evelyn Lavu, Pranav Patel, Bandana Choudhury, Camilla Rodrigues, Sarabjit Chadha, Mubin Kazi, Aurélien Macé, Pamela Nabeta, Catharina Boehme, Raman R Gangakhedkar, Sanjay Sarin, Ephrem Tesfaye, Eduardo Gotuzzo, Philipp du Cros, Srikanth Tripathy, Morten Ruhwald, Manjula Singh, Claudia M Denkinger, Samuel G Schumacher, Truenat Trial Consortium, Members of the Truenat Trial Consortium: A prospective multicentre diagnostic accuracy study for the Truenat tuberculosis assays CONCLUSION: We found the performance of Molbio's Truenat MTB, MTB Plus and MTB-RIF Dx assays to be comparable to that of the Xpert MTB/RIF assay. Performing the Truenat tests in primary healthcare centres with very limited infrastructure was feasible. These data supported the development of a World ... 5/29/2021
Yassin Naga, Mahendran Jayaraj, Yousif Elmofti, Annie Hong, Gordon Ohning Intraluminal Endovascular Coil Migration: A Rare Complication Post-Embolization of the Gastroduodenal Artery for a Previously Bleeding Duodenal Ulcer Transarterial angiographic embolization is a highly effective, safe treatment for non-variceal upper gastrointestinal bleeding refractory to endoscopic intervention. However, intraluminal coil migration is a possible complication. Coil migration, while usually a self-limiting process, can lead to si... 5/27/2021
Shajan Peter, Ji Young Bang, Shyam Varadarajulu Single-use duodenoscopes: where are we and where are we going? PURPOSE OF REVIEW: Given the growing concerns about infection transmission from use of contaminated reusable duodenoscopes, technological advancements have been made that vary from modifications of existing designs to development of single-use devices. 5/19/2021
Jeska A Fritzsche, Paul Fockens, Marc Barthet, Marco J Bruno, David L Carr-Locke, Guido Costamagna, Gregory A Coté, Pierre H Deprez, Marc Giovannini, Gregory B Haber, Robert H Hawes, Jong Jin Hyun, Takao Itoi, Eisuke Iwasaki, Leena Kylänpaä, Horst Neuhaus, Jeong Youp Park, D Nageshwar Reddy, Arata Sakai, Michael J Bourke, Rogier P Voermans Expert consensus on endoscopic papillectomy using a Delphi process CONCLUSIONS: This is the first step in developing an international consensus-based algorithm for endoscopic management of papillary adenomas. Surprisingly, in many areas consensus could not be achieved. These aspects should be the focus of future studies. 4/22/2021
Brian Bressler, Andres Yarur, Mark S Silverberg, Marielle Bassel, Emanuelle Bellaguarda, Chris Fourment, Anthie Gatopoulou, Pantelis Karatzas, Uri Kopylov, George Michalopoulos, Spyridon Michopoulos, Udayakumar Navaneethan, David T Rubin, Jesse Siffledeen, Andrew Singh, Konstantinos Soufleris, Dara Stein, Dirk Demuth, Gerassimos J Mantzaris Vedolizumab and Anti-Tumour Necrosis Factor α Real-World Outcomes in Biologic-Naïve Inflammatory Bowel Disease Patients: Results from the EVOLVE Study CONCLUSION: In this real-world setting, first-line biologic therapy in biologic-naïve patients with UC and CD demonstrated that vedolizumab and anti-TNFα treatments were equally effective at controlling disease symptoms, but vedolizumab has a more favourable safety profile. 3/31/2021
Vittorio Romeo Terrigno, Daniel Anthony Ricketti, Pranav Patel, Satyajeet Roy Recurrent chronic thromboembolic disease despite optimal anticoagulation in setting of recent COVID-19 infection We present a case of a 38-year-old man with a history of chronic thromboembolic pulmonary hypertension on therapeutic anticoagulation and recent hospitalisation for COVID-19 disease who was hospitalised for recurrent acute pulmonary embolism despite therapeutic anticoagulation with warfarin (Interna... 1/29/2021
Ahmed Abd El Wahed, Pranav Patel, Melanie Maier, Corinna Pietsch, Dana Rüster, Susanne Böhlken-Fascher, Jonas Kissenkötter, Ole Behrmann, Michael Frimpong, Moussa Moïse Diagne, Martin Faye, Ndongo Dia, Mohamed A Shalaby, Haitham Amer, Mahmoud Elgamal, Ali Zaki, Ghada Ismail, Marco Kaiser, Victor M Corman, Matthias Niedrig, Olfert Landt, Ousmane Faye, Amadou A Sall, Frank T Hufert, Uwe Truyen, Uwe G Liebert, Manfred Weidmann Suitcase Lab for Rapid Detection of SARS-CoV-2 Based on Recombinase Polymerase Amplification Assay In March 2020, the SARS-CoV-2 virus outbreak was declared as a world pandemic by the World Health Organization (WHO). The only measures for controlling the outbreak are testing and isolation of infected cases. Molecular real-time polymerase chain reaction (PCR) assays are very sensitive but require ... 1/20/2021
Ji Young Bang, Robert Hawes, Shyam Varadarajulu Equivalent performance of single-use and reusable duodenoscopes in a randomised trial CONCLUSION: Given the overall safety profile and similar technical performance, single-use duodenoscopes represent an alternative to reusable duodenoscopes for performing low-complexity ERCP procedures in experienced hands. 9/8/2020
B Joseph Elmunzer, Jose Serrano, Amitabh Chak, Steven A Edmundowicz, Georgios I Papachristou, James M Scheiman, Vikesh K Singh, Shyam Varadarajulu, John J Vargo, Field F Willingham, Todd H Baron, Gregory A Coté, Joseph Romagnuolo, April Wood-Williams, Emily K Depue, Rebecca L Spitzer, Cathie Spino, Lydia D Foster, Valerie Durkalski, SVI study group and the United States Cooperative for Outcomes Research in Endoscopy (USCORE) Correction to: Rectal indomethacin alone versus indomethacin and prophylactic pancreatic stent placement for preventing pancreatitis after ERCP: study protocol for a randomized controlled trial An amendment to this paper has been published and can be accessed via the original article. 6/5/2020
Yan Chen, Qiao Yu, Francis A Farraye, Gursimran S Kochhar, Charles N Bernstein, Udayakumar Navaneethan, Kaicun Wu, Jie Zhong, David A Schwartz, Hao Wu, Jing-Jing Zheng, Marietta Iacucci, Ravi P Kiran, Bo Shen Patterns of endoscopy during COVID-19 pandemic: a global survey of interventional inflammatory bowel disease practice CONCLUSIONS: Cancellation of elective and emergent endoscopy in IBD care during the pandemic was common. Few respondents reported that their patients' disease conditions worsened due to the cancellation of the endoscopy procedure. Most respondents voiced the need for proper PPE during the procedure ... 6/1/2020
Mandeep S Sawhney, Mohammad Bilal, Heiko Pohl, Vladimir M Kushnir, Mouen A Khashab, Allison R Schulman, Tyler M Berzin, Prabhleen Chahal, V Raman Muthusamy, Shyam Varadarajulu, Subhas Banerjee, Gregory G Ginsberg, Gottumukkala S Raju, Joseph D Feuerstein Triaging advanced GI endoscopy procedures during the COVID-19 pandemic: consensus recommendations using the Delphi method CONCLUSIONS: By using a Modified Delphi method that prioritized patient-important outcomes, we developed consensus recommendations on procedural timing for common indications for advanced endoscopy. These recommendations and the structured decision framework provided by our study can inform decision... 5/20/2020
Banreet Singh Dhindsa, Harmeet Singh Mashiana, Amaninder Dhaliwal, Babu P Mohan, Mahendran Jayaraj, Harlan Sayles, Shailender Singh, Gordon Ohning, Ishfaq Bhat, Douglas G Adler EUS-guided biliary drainage: A systematic review and meta-analysis ERCP is the current procedure of choice for patients with jaundice caused by biliary obstruction. EUS-guided biliary drainage (EUS-BD) has emerged as an alternative to ERCP in patients requiring biliary drainage. The aim of the study was to conduct a systematic review and meta-analysis to report the... 4/17/2020
Basile Njei, Thomas R McCarty, Thiruvengadam Muniraj, Prabin Sharma, Priya A Jamidar, Harry R Aslanian, Shyam Varadarajulu, Udayakumar Navaneethan Comparative effectiveness of pharmacologic and endoscopic interventions for prevention of post-ERCP pancreatitis: a network meta-analysis Background and study aims While several interventions may decrease risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis, it remains unclear whether one strategy is superior to others. The purpose of this study was to compare the effectiveness of pharmacologic and endoscopi... 1/11/2020
Mohamed Azab, Shishira Bharadwaj, Mahendran Jayaraj, Annie S Hong, Pejman Solaimani, Mohamad Mubder, Hyeyoung Yeom, Ji Won Yoo, Michael L Volk Safety of endoscopic retrograde cholangiopancreatography (ERCP) in pregnancy: A systematic review and meta-analysis CONCLUSIONS: ERCP done by experienced endoscopists is a safe procedure during pregnancy. Radiation-free techniques appear to reduce the rates of nonpregnancy-related complications, but not of fetal and pregnancy-related complications. 11/21/2019
Haruhiro Inoue, Hironari Shiwaku, Yasutoshi Kobayashi, Philip W Y Chiu, Robert H Hawes, Horst Neuhaus, Guido Costamagna, Stavros N Stavropoulos, Norio Fukami, Stefan Seewald, Manabu Onimaru, Hitomi Minami, Shinwa Tanaka, Yuto Shimamura, Esperanza Grace Santi, Kevin Grimes, Hisao Tajiri Statement for gastroesophageal reflux disease after peroral endoscopic myotomy from an international multicenter experience It has been 10 years since peroral endoscopic myotomy (POEM) was reported for the first time, and POEM has currently become the standard treatment for achalasia and related disorders globally because it is less invasive and has a higher curative effect than conventional therapeutic methods. However,... 9/28/2019
Mohamad Mubder, Mohamed Azab, Mahendran Jayaraj, Chad Cross, Daisy Lankarani, Banreet Dhindsa, Jen-Jung Pan, Gordon Ohning Autoimmune hepatitis in patients with human immunodeficiency virus infection: A systematic review of the published literature CONCLUSION: Although rare, but AIH can develop in patients with HIV and physicians should consider it in the differential diagnosis for HIV patients presented with abnormal liver function tests, especially after excluding hepatitis C virus and drug-induced liver injury.Patients with immune deficienc... 9/14/2019
ASGE Technology Committee, Harry R Aslanian, Amrita Sethi, Manoop S Bhutani, Adam J Goodman, Kumar Krishnan, David R Lichtenstein, Joshua Melson, Udayakumar Navaneethan, Rahul Pannala, Mansour A Parsi, Allison R Schulman, Shelby A Sullivan, Nirav Thosani, Guru Trikudanathan, Arvind J Trindade, Rabindra R Watson, John T Maple ASGE guideline for endoscopic full-thickness resection and submucosal tunnel endoscopic resection With the development of reliable endoscopic closure techniques and tools, endoscopic full-thickness resection (EFTR) is emerging as a therapeutic option for the treatment of subepithelial tumors and epithelial neoplasia with significant fibrosis. EFTR may be categorized as "exposed" and "nonexposed.... 8/8/2019
ASGE technology committee, Mansour A Parsi, Allison R Schulman, Harry R Aslanian, Manoop S Bhutani, Kuman Krishnan, David R Lichtenstein, Joshua Melson, Udayakumar Navaneethan, Rahul Pannala, Amrita Sethi, Guru Trikudanathan, Arvind J Trindade, Rabindra R Watson, John T Maple, ASGE Technology Committee Chair Devices for endoscopic hemostasis of nonvariceal GI bleeding (with videos) CONCLUSIONS: Endoscopic evaluation and treatment remains a cornerstone in the management of nonvariceal upper- and lower-GI bleeding. A variety of devices is available for hemostasis of bleeding lesions in the GI tract. Other than injection therapy, which should not be used as monotherapy, there are... 7/24/2019
Clayton M Spiceland, B Joseph Elmunzer, Samuel Paros, Logan Roof, Molly McVey, Robert Hawes, Brenda J Hoffman, Puja S Elias Salvage cryotherapy in patients undergoing endoscopic eradication therapy for complicated Barrett's esophagus Background and study aims Some patients with dysplastic Barrett's esophagus (BE) experience suboptimal response to radiofrequency ablation (RFA), endoscopic mucosal resection (EMR), or the combination. Cryotherapy has been used as salvage therapy in these patients, but outcomes data are limited. We ... 7/9/2019
Mahendran Jayaraj, Babu P Mohan, Harmeet Mashiana, Rajesh Krishnamoorthi, Douglas G Adler Safety and efficacy of combined antegrade and retrograde endoscopic dilation for complete esophageal obstruction: a systematic review and meta-analysis CONCLUSIONS: The CARD procedure for CEO has a high technical success rate, but also a high rate of repeat dilations. Given its complexity and associated adverse events, this procedure should be restricted to centers with a high level of expertise. 7/3/2019
Babu P Mohan, Mohammed Shakhatreh, Rajat Garg, Ravishankar Asokkumar, Mahendran Jayaraj, Suresh Ponnada, Udayakumar Navaneethan, Douglas G Adler Comparison of Franseen and fork-tip needles for EUS-guided fine-needle biopsy of solid mass lesions: A systematic review and meta-analysis Franseen-tip and Fork-tip needles have been widely used in EUS guided fine-needle biopsy (FNB) of solid organs. There is conflicting data on the performance of these needles and unanswered questions on the ideal number of needle-passes and the requirement of an onsite cytopathologist (ROSE). We cond... 6/29/2019
Udayakumar Navaneethan, Xiang Zhu, Mansour A Parsi, Shyam Varadarajulu Pre-operative biliary drainage is associated with shortened survival time in patients with cholangiocarcinoma CONCLUSIONS: PBD appears negative impact on long-term survival in patients with potentially resectable CCA and should be avoided if possible. 6/21/2019
Babu P Mohan, Ravishankar Asokkumar, Mohammed Shakhatreh, Rajat Garg, Suresh Ponnada, Udayakumar Navaneethan, Douglas G Adler Adverse events with lumen-apposing metal stents in endoscopic gallbladder drainage: A systematic review and meta-analysis CONCLUSION: We report an overall AE rate of 13% with LAMS in EUS-GBD. Early AE risk appears to be 6.5% and delayed AE risk appears to be 8%. Our results are analyzed out of good-quality studies, with minimal to zero heterogeneity. 5/23/2019
Ramprasad Jegadeesan, Muhammad Aziz, Madhav Desai, Tharani Sundararajan, Venkata Subhash Gorrepati, Viveksandeep Thogulva Chandrasekar, Mahendran Jayaraj, Pratiksha Singh, Ahmed Saeed, Tarun Rai, Abhishek Choudhary, Alessandro Repici, Cesare Hassan, Lorenzo Fuccio, Prateek Sharma Hot snare vs. cold snare polypectomy for endoscopic removal of 4 - 10 mm colorectal polyps during colonoscopy: a systematic review and meta-analysis of randomized controlled studies Introduction In recent years, cold snare polypectomy (CSP) has increasingly been used over hot snare polypectomy (HSP) for the removal of colorectal polyps (4 - 10 mm in size). However, the optimal technique (CSP vs. HSP), in terms of complete polyp resection and complications, is uncertain. Our aim... 5/11/2019
Babu P Mohan, Mahendran Jayaraj, Ravishankar Asokkumar, Mohammed Shakhatreh, Parul Pahal, Suresh Ponnada, Udayakumar Navaneethan, Douglas G Adler Lumen apposing metal stents in drainage of pancreatic walled-off necrosis, are they any better than plastic stents? A systematic review and meta-analysis of studies published since the revised Atlanta classification of pancreatic fluid collections Lumen-apposing metal stents (LAMS) are increasingly being used in the drainage of pancreatic walled-off necrosis (WON). Best choice of stent is subject to argument, and studies are varied in the reported outcomes between LAMS and plastic stents (PS) to this end. We conducted a comprehensive search o... 4/23/2019
Patrick Marks, Sarah Garcia, Alvaro Martinez Barrio, Kamila Belhocine, Jorge Bernate, Rajiv Bharadwaj, Keith Bjornson, Claudia Catalanotti, Josh Delaney, Adrian Fehr, Ian T Fiddes, Brendan Galvin, Haynes Heaton, Jill Herschleb, Christopher Hindson, Esty Holt, Cassandra B Jabara, Susanna Jett, Nikka Keivanfar, Sofia Kyriazopoulou-Panagiotopoulou, Monkol Lek, Bill Lin, Adam Lowe, Shazia Mahamdallie, Shamoni Maheshwari, Tony Makarewicz, Jamie Marshall, Francesca Meschi, Christopher J O'Keefe, Heather Ordonez, Pranav Patel, Andrew Price, Ariel Royall, Elise Ruark, Sheila Seal, Michael Schnall-Levin, Preyas Shah, David Stafford, Stephen Williams, Indira Wu, Andrew Wei Xu, Nazneen Rahman, Daniel MacArthur, Deanna M Church Resolving the full spectrum of human genome variation using Linked-Reads Large-scale population analyses coupled with advances in technology have demonstrated that the human genome is more diverse than originally thought. To date, this diversity has largely been uncovered using short-read whole-genome sequencing. However, these short-read approaches fail to give a comple... 3/22/2019
Ashutosh R Mohapatra, Priyam Choudhury, Pranav S Patel, Rohit S Malhotra, Ankur B Patil An Unusual Case of Giant Cell Tumor of the Distal Tibia CONCLUSION: The patient at 2-year follow-up is doing well, walking without any pain, comfortably and with a full range of motion of the ankle joint with no signs of recurrence. 1/29/2019
Matthias Niedrig, Pranav Patel, Ahmed Abd El Wahed, Regina Schädler, Sergio Yactayo Find the right sample: A study on the versatility of saliva and urine samples for the diagnosis of emerging viruses CONCLUSIONS: Considering the experience using non-invasive sampling for the diagnostic of emerging viral diseases, it seems important to perform an investigation using alternative samples for routine diagnostics. Moreover, during an outbreak situation, evaluation of appropriate sampling and further ... 12/31/2018
Udayakumar Navaneethan, Xiang Zhu, Dennisdhilak Lourdusamy, Vennisvasanth Lourdusamy, Bo Shen, Ravi Kiran Colorectal cancer resection rates in patients with inflammatory bowel disease: a population-based study CONCLUSIONS: CRC resection rates among IBD patients have continued to decrease annually from 1995 to 2012. There is a population-level decrease in resection of both proximal and distal CRC reflecting a decreasing incidence of IBD-related CRC incidence in the USA. 11/16/2018
Harmeet Singh Mashiana, Mahendran Jayaraj, Babu Pappu Mohan, Gordon Ohning, Douglas G Adler Comparison of outcomes for supine vs. prone position ERCP: a systematic review and meta-analysis Background While endoscopic retrograde cholangiopancreatography (ERCP) is usually performed in the prone position, some studies have advocated for ERCP in the supine position. Studies comparing the technical success and safety outcomes have shown variable results. We performed a systematic review an... 11/10/2018
ASGE Technology Committee, Rabindra R Watson, Mansour A Parsi, Harry R Aslanian, Adam J Goodman, David R Lichtenstein, Joshua Melson, Udayakumar Navaneethan, Rahul Pannala, Amrita Sethi, Shelby A Sullivan, Nirav C Thosani, Guru Trikudanathan, Arvind J Trindade, John T Maple Biliary and pancreatic lithotripsy devices CONCLUSIONS: Several lithotripsy techniques have been described that vary with respect to ease of use, generalizability, and cost. Overall, lithotripsy is a safe and effective treatment for difficult biliary and pancreatic duct stones. 11/8/2018
Dixitkumar Jayantibhai Kapadiya, Paresh V Dave, Bhavin Vadera, Pranav Govindbhai Patel, Sudhir Chawla, Deepak Saxena Assessment of Tuberculosis Prevalence in Newly Diagnosed Human Immunodeficiency Virus-Infected Adults Attending Care and Treatment Center in Gujarat, India CONCLUSION: A high prevalence of TB was found among newly diagnosed HIV-infected adults attending ART center for care and treatment. The prevalence of pulmonary and extrapulmonary TB was almost equal. Chances of TB disease were more with depletion of CD4 counts. The study highlights urgent need of i... 10/9/2018
Manfred Weidmann, Ousmane Faye, Oumar Faye, Ahmed Abd El Wahed, Pranav Patel, Christophe Batejat, Jean Claude Manugerra, Aimee Adjami, Matthias Niedrig, Frank T Hufert, Amadou A Sall Development of Mobile Laboratory for Viral Hemorrhagic Fever Detection in Africa CONCLUSIONS: The developed mobile laboratory successfully enabled local teams to perform rapid disgnostic testing for viral hemorrhagic fever. 6/20/2018
Ji Young Bang, Udayakumar Navaneethan, Muhammad K Hasan, Bryce Sutton, Robert Hawes, Shyam Varadarajulu Non-superiority of lumen-apposing metal stents over plastic stents for drainage of walled-off necrosis in a randomised trial CONCLUSION: Except for procedure duration, there was no significant difference in treatment outcomes between LAMS and plastic stents. To minimise adverse events with LAMS, patients should undergo follow-up imaging and stent removal at 3 weeks if WON has resolved. 6/3/2018
Benjamin Lopez-Jimena, Michaël Bekaert, Mohammed Bakheit, Sieghard Frischmann, Pranav Patel, Etienne Simon-Loriere, Louis Lambrechts, Veasna Duong, Philippe Dussart, Graham Harold, Cheikh Fall, Oumar Faye, Amadou Alpha Sall, Manfred Weidmann Development and validation of four one-step real-time RT-LAMP assays for specific detection of each dengue virus serotype CONCLUSIONS/SIGNIFICANCE: We have shown a novel approach to design LAMP primers that makes use of fast growing sequence databases. The DENV1 and DENV2 assays were validated with viral RNA extracted clinical samples, showing very good performance parameters. 5/30/2018
Rohit Malhotra, Ashutosh Mohapatra, Geetika Arora, Priyam Choudhury, Hitesh Joshi, Pranav Patel Ponseti Technique for the Management of Congenital Talipes Equinovarus in a Rural Set-Up in India: Experience of 356 Patients Congenital talipes equinovarus (CTEV), also known as clubfoot, is a complex congenital deformity of the foot that, left untreated, can limit a person's mobility by making it difficult and painful to walk. Worldwide, 80% of children born with clubfoot are in low- and middle-income countries. The mana... 4/13/2018
Parag Brahmbhatt, Jason Ross, Atif Saleem, Jason McKinney, Pranav Patel, Sarah Khan, Chakradhar M Reddy, Mark Young Recurrent Adenocarcinoma of Colon Presenting as Duodenal Metastasis With Partial Gastric Outlet Obstruction: A Case Report With Review of Literature Colorectal cancer is one of the leading causes of cancer related deaths in western world. While most common site for metastasis for colon cancer is liver, lung, and the peritoneum, metastasis to various other organs such as brain, bones and thyroid has been reported. Metastatic lesions to the small ... 11/18/2017
Carlo Fischer, Maria C Torres, Pranav Patel, Andres Moreira-Soto, Ernest A Gould, Rémi N Charrel, Xavier de Lamballerie, Rita Maria Ribeiro Nogueira, Patricia C Sequeira, Cintia D S Rodrigues, Beate M Kümmerer, Christian Drosten, Olfert Landt, Ana Maria Bispo de Filippis, Jan Felix Drexler Lineage-Specific Real-Time RT-PCR for Yellow Fever Virus Outbreak Surveillance, Brazil The current yellow fever outbreak in Brazil prompted widespread yellow fever virus (YFV) vaccination campaigns, imposing a responsibility to distinguish between vaccine- and wild-type YFV-associated disease. We developed novel multiplex real-time reverse transcription PCRs that differentiate between... 9/27/2017
Udayakumar Navaneethan, Dennisdhilak Lourdusamy, Norma G Gutierrez, Xiang Zhu, John J Vargo, Mansour A Parsi New approach to decrease post-ERCP adverse events in patients with primary sclerosing cholangitis CONCLUSION: Biliary aspiration and avoidance of stenting approach after dilation of strictures during ERCP in PSC patients appears to be associated with decreased risk of cholangitis and overall AEs. Future prospective randomized controlled trials are needed to validate our observation. 8/10/2017
Yueqiao Qu, Teng Ma, Youmin He, Mingyue Yu, Jiang Zhu, Yusi Miao, Cuixia Dai, Pranav Patel, K Kirk Shung, Qifa Zhou, Zhongping Chen Miniature probe for mapping mechanical properties of vascular lesions using acoustic radiation force optical coherence elastography Cardiovascular diseases are the leading cause of fatalities in the United States. Atherosclerotic plaques are one of the primary complications that can lead to strokes and heart attacks if left untreated. It is essential to diagnose the disease early and distinguish vulnerable plaques from harmless ... 7/7/2017
Altaf Dawood, Syed Abdul Basit, Mahendran Jayaraj, Robert G Gish Drugs in Development for Hepatitis B With high morbidity and mortality worldwide, there is great interest in effective therapies for chronic hepatitis B (CHB) virus. There are currently several dozen investigational agents being developed for treatment of CHB. They can be broadly divided into two categories: (1) direct-acting antiviral... 6/30/2017
Heinz Ellerbrok, Sonja Jacobsen, Pranav Patel, Toni Rieger, Markus Eickmann, Stephan Becker, Stephan Günther, Dhamari Naidoo, Livia Schrick, Kathrin Keeren, Angelina Targosz, Anette Teichmann, Pierre Formenty, Matthias Niedrig External quality assessment study for ebolavirus PCR-diagnostic promotes international preparedness during the 2014 - 2016 Ebola outbreak in West Africa During the recent Ebola outbreak in West Africa several international mobile laboratories were deployed to the mainly affected countries Guinea, Sierra Leone and Liberia to provide ebolavirus diagnostic capacity. Additionally, imported cases and small outbreaks in other countries required global pre... 5/2/2017
Udayakumar Navaneethan, Basile Njei, Xiang Zhu, Kiran Kommaraju, Mansour A Parsi, Shyam Varadarajulu Safety of ERCP in patients with liver cirrhosis: a national database study Background and aims Given the limited data on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in patients with liver cirrhosis, we attempted to evaluate this question using a large national database. Methods We conducted a matched case - control study using the 2010 National Inpa... 4/11/2017
Ahmed Abd El Wahed, Sabri Saeed Sanabani, Oumar Faye, Rodrigo Pessôa, João Veras Patriota, Ricardo Rodrigues Giorgi, Pranav Patel, Susanne Böhlken-Fascher, Olfert Landt, Matthias Niedrig, Paolo Marinho de Andrade Zanotto, Claus Peter Czerny, Amadou A Sall, Manfred Weidmann Rapid Molecular Detection of Zika Virus in Acute-Phase Urine Samples Using the Recombinase Polymerase Amplification Assay CONCLUSIONS/SIGNIFICANCE: The developed assay is a promising platform for rapid point of need detection of ZIKV in low resource settings and elsewhere (e.g. during mass gathering). 2/28/2017
Glenn Harvin, Eslam Ali, Amit Raina, William Leland, Sabeen Abid, Zahid Vahora, Hossein Movahed, Sumyra Kachru, Rick Tee Patients presenting for colonoscopy: A great opportunity to screen for sleep apnea CONCLUSION: Risk for OSA is extremely common in a population presenting for a routine colonoscopy, and screening at the time of a colonoscopy offers an excellent opportunity to identify these patients. 12/3/2016
Glenn Harvin, Eslam Ali, Amit Raina, William Leland, Sabeen Abid, Zahid Vahora, Hossein Movahed, Sumyra Kachru, Rick Tee Airway observations during upper endoscopy predicting obstructive sleep apnea CONCLUSIONS: The results of our pilot study represent preliminary data regarding the use of upper endoscopy as a potential tool to evaluate patients for obstructive sleep apnea. 10/7/2016
Pranav Patel, Ahmed Abd El Wahed, Oumar Faye, Pauline Prüger, Marco Kaiser, Sasikanya Thaloengsok, Sukathida Ubol, Anavaj Sakuntabhai, Isabelle Leparc-Goffart, Frank T Hufert, Amadou A Sall, Manfred Weidmann, Matthias Niedrig A Field-Deployable Reverse Transcription Recombinase Polymerase Amplification Assay for Rapid Detection of the Chikungunya Virus CONCLUSIONS/SIGNIFICANCE: The developed RT-RPA assay represents a promising method for the molecular detection of CHIKV at point of need. 9/30/2016
Sunina Nathoo, William A Hood, Sara Keihanian, Amy L Collinsworth, Sarah C Glover Tofacitinib for the treatment of tumor necrosis factor-α inhibitor refractory esophageal Crohn's disease: a case report CONCLUSION: Esophageal Crohn's disease is likely underdiagnosed but is an important consideration in a patient with new symptoms of dysphagia and known Crohn's disease. Tofacitinib, while a novel agent, could have a role in the treatment of esophageal Crohn's disease that does not improve with inten... 9/25/2016
Madhusudhan R Sanaka, Ramprasad Jegadeesan, Prashanthi N Thota, Udayakumar Navaneethan, Rocio Lopez, Sudish C Murthy, Siva Raja Two-Person Technique of Peroral Endoscopic Myotomy for Achalasia with an Advanced Endoscopist and a Thoracic Surgeon: Initial Experience Background and Aims. We initiated peroral endoscopic myotomy (POEM) utilizing a two-person technique with combination of an advanced endoscopist and a thoracic surgeon with complementary skills. Our aim was to determine the feasibility and outcomes in initial 20 patients. Methods. In this observatio... 9/16/2016
Udayakumar Navaneethan, Muhammad K Hasan, Vennisvasanth Lourdusamy, Xiang Zhu, Robert H Hawes, Shyam Varadarajulu Efficacy and safety of endoscopic mucosal resection of non-ampullary duodenal polyps: a systematic review CONCLUSION: EMR appears to be a safe and effective therapeutic option for management of sporadic non-ampullary duodenal polyps. Long-term endoscopic surveillance is required to manage and treat recurrent disease. 8/25/2016
Ji Young Bang, Udayakumar Navaneethan, Muhammad K Hasan, Robert H Hawes, Shyam Varadarajulu EUS correlates of disconnected pancreatic duct syndrome in walled-off necrosis CONCLUSIONS: We report EUS findings indicating the presence of DPDS. These findings may have significant clinical implications for the management of patients with WON. 8/20/2016
Clovis Arcoverde Freitas-Neto, Douglas Pigosso, Katia Delalíbera Pacheco, Viviane Oliveira Pereira, Pranav Patel, Luiz Guilherme Freitas, Marcos Pereira Ávila Spontaneous closure of macular hole following blunt trauma Ocular trauma can result in macular hole and it can lead to complete loss of central vision. We are reporting a case of traumatic macular hole associated with retinal hemorrhages and choroidal ruptures with spontaneous resolution and total vision recovery. 7/20/2016
Fnu Asad-Ur-Rahman, Aamer Abbass, Umair Majeed, Udayakumar Navaneethan Melanoma Metastasizing to the Small Intestine: A Case Report Illustrating Symptomatic and Asymptomatic Involvement Symptomatic gastrointestinal (GI) involvement of melanoma is rare, however, it is a frequent autopsy finding in patients with primary cutaneous melanoma. We present a case of metastatic cutaneous melanoma with initial asymptomatic jejunal involvement as found on a positron emission tomography (PET) ... 6/23/2016
Joshua P Smith, J Pablo Arnoletti, Shyam Varadarajulu, Desiree E Morgan Post-pancreatitis Fat Necrosis Mimicking Carcinomatosis Acute pancreatitis can result in retroperitoneal fat necrosis, typically occurring in the peripancreatic region, with extension into the transverse mesocolon, omentum and mesenteric root. When evaluated with contrast enhanced computed tomography (CECT), acute peripancreatic post necrotic collections... 6/16/2016
Prafulla Herode, Abhijeet Shroff, Pranav Patel, Pallav Aggarwal, Vishal Mandlewala A Rare Case of Pubic Ramus Osteochondroma CONCLUSION: Thus osteochondroma of the pelvis should be kept in mind as a differential diagnosis when evaluating mass in pelvis. Also these have to be removed when they pose cosmetic problems. 6/15/2016
Mouen A Khashab, Schalk Van der Merwe, Rastislav Kunda, Mohamad H El Zein, Anthony Y Teoh, Fernando P Marson, Carlo Fabbri, Ilaria Tarantino, Shyam Varadarajulu, Rani J Modayil, Stavros N Stavropoulos, Irene Peñas, Saowanee Ngamruengphong, Vivek Kumbhari, Joseph Romagnuolo, Raj Shah, Anthony N Kalloo, Manuel Perez-Miranda, Everson L Artifon Prospective international multicenter study on endoscopic ultrasound-guided biliary drainage for patients with malignant distal biliary obstruction after failed endoscopic retrograde cholangiopancreatography CONCLUSION: This study on EUS-BD demonstrates excellent efficacy and safety of EUS-BD when performed by experts. 4/20/2016
Michael Epstein, David A Johnson, Robert Hawes, Nathan Schmulewitz, Arvydas D Vanagunas, E Roderich Gossen, Weining Z Robieson, Susan Eaton, Jordan Dubow, Krai Chatamra, Janet Benesh Long-Term PEG-J Tube Safety in Patients With Advanced Parkinson's Disease CONCLUSIONS: In conclusion, incidences of PEG-J AEs with the LCIG delivery system and PEG-J longevity were compared favorably with ranges described in the PEG/PEG-J literature. A low discontinuation rate in this study suggests acceptable procedural outcomes and AE rates in PD patients treated with t... 4/1/2016
Jason Chertoff, Sunina Nathoo Decompensated Liver Cirrhosis Presenting as a Spontaneous Left-Sided Bacterial Empyema Decompensation of cirrhosis presents with ascites, encephalopathy, variceal bleeding, or spontaneous bacterial peritonitis. Infrequently, decompensation can result from spontaneous bacterial empyema. A 38-year-old man presented with fevers, chills, and dyspnea. Labs were significant for leukocytosis... 3/10/2016
B Joseph Elmunzer, Jose Serrano, Amitabh Chak, Steven A Edmundowicz, Georgios I Papachristou, James M Scheiman, Vikesh K Singh, Shyam Varadarajulu, John J Vargo, Field F Willingham, Todd H Baron, Gregory A Coté, Joseph Romagnuolo, April Wood-Williams, Emily K Depue, Rebecca L Spitzer, Cathie Spino, Lydia D Foster, Valerie Durkalski, SVI study group and the United States Cooperative for Outcomes Research in Endoscopy (USCORE) Rectal indomethacin alone versus indomethacin and prophylactic pancreatic stent placement for preventing pancreatitis after ERCP: study protocol for a randomized controlled trial BACKGROUND: The combination of prophylactic pancreatic stent placement (PSP) - a temporary plastic stent placed in the pancreatic duct - and rectal non-steroidal anti-inflammatory drugs (NSAIDs) is recommended for preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PE... 3/5/2016
Grace X Y Zheng, Billy T Lau, Michael Schnall-Levin, Mirna Jarosz, John M Bell, Christopher M Hindson, Sofia Kyriazopoulou-Panagiotopoulou, Donald A Masquelier, Landon Merrill, Jessica M Terry, Patrice A Mudivarti, Paul W Wyatt, Rajiv Bharadwaj, Anthony J Makarewicz, Yuan Li, Phillip Belgrader, Andrew D Price, Adam J Lowe, Patrick Marks, Gerard M Vurens, Paul Hardenbol, Luz Montesclaros, Melissa Luo, Lawrence Greenfield, Alexander Wong, David E Birch, Steven W Short, Keith P Bjornson, Pranav Patel, Erik S Hopmans, Christina Wood, Sukhvinder Kaur, Glenn K Lockwood, David Stafford, Joshua P Delaney, Indira Wu, Heather S Ordonez, Susan M Grimes, Stephanie Greer, Josephine Y Lee, Kamila Belhocine, Kristina M Giorda, William H Heaton, Geoffrey P McDermott, Zachary W Bent, Francesca Meschi, Nikola O Kondov, Ryan Wilson, Jorge A Bernate, Shawn Gauby, Alex Kindwall, Clara Bermejo, Adrian N Fehr, Adrian Chan, Serge Saxonov, Kevin D Ness, Benjamin J Hindson, Hanlee P Ji Haplotyping germline and cancer genomes with high-throughput linked-read sequencing Haplotyping of human chromosomes is a prerequisite for cataloguing the full repertoire of genetic variation. We present a microfluidics-based, linked-read sequencing technology that can phase and haplotype germline and cancer genomes using nanograms of input DNA. This high-throughput platform prepar... 2/2/2016
Jiawen Li, Teng Ma, Dilbahar Mohar, Earl Steward, Mingyue Yu, Zhonglie Piao, Youmin He, K Kirk Shung, Qifa Zhou, Pranav M Patel, Zhongping Chen Ultrafast optical-ultrasonic system and miniaturized catheter for imaging and characterizing atherosclerotic plaques in vivo Atherosclerotic coronary artery disease (CAD) is the number one cause of death worldwide. The majority of CAD-induced deaths are due to the rupture of vulnerable plaques. Accurate assessment of plaques is crucial to optimize treatment and prevent death in patients with CAD. Current diagnostic techni... 12/19/2015
C Mel Wilcox, Hwasoon Kim, Toni Seay, Shyam Varadarajulu Choice of plastic or metal stent for patients with jaundice with pancreaticobiliary malignancy using simple clinical tools: a prospective evaluation CONCLUSIONS: The decision whether to place a plastic stent or SEMS for patients with distal malignant obstructive jaundice may be based on simple clinical tools resulting in low rates of reintervention. 10/14/2015
Suzan D Pas, Pranav Patel, Chantal Reusken, Cristina Domingo, Victor M Corman, Christian Drosten, Ronald Dijkman, Volker Thiel, Norbert Nowotny, Marion P G Koopmans, Matthias Niedrig First international external quality assessment of molecular diagnostics for Mers-CoV CONCLUSIONS: The first external quality assessment MERS-CoV panel gives a good insight in molecular diagnostic techniques and their performances for sensitive and specific detection of MERS-CoV RNA globally. Overall, all laboratories were capable of detecting MERS-CoV with some differences in sensit... 7/26/2015
David L Diehl, Amitpal S Johal, Harshit S Khara, Stavros N Stavropoulos, Mohammed Al-Haddad, Jayapal Ramesh, Shyam Varadarajulu, Harry Aslanian, Stuart R Gordon, Frederick K Shieh, Jonh J Pineda-Bonilla, Theresa Dunkelberger, Dibson D Gondim, Eric Z Chen Endoscopic ultrasound-guided liver biopsy: a multicenter experience CONCLUSIONS: EUS-guided LB was a safe technique that yields tissue adequate for diagnosis among 98 % of patients evaluated. 7/15/2015
Anthony Yuen Bun Teoh, Lawrence Khek Yu Ho, Vinay Kumar Dhir, Zhen Dong Jin, Mitsuhiro Kida, Dong Wan Seo, Hsui Po Wang, Ai Ming Yang, Kenneth Frank Binmoeller, Shyam Varadarajulu A multi-institutional survey on the practice of endoscopic ultrasound (EUS) guided pseudocyst drainage in the Asian EUS group CONCLUSION: This was the first Asia wide survey in the practice of pseudocyst drainage. There were wide variations in practice and randomized studies are urgently needed to establish the best approach for management of this condition. There is also a pressing need for establishment of a consensus fo... 7/3/2015
Udayakumar Navaneethan, John J Vargo, K V Narayanan Menon, Madhusudhan R Sanaka, Chung-Jyi Tsai Impact of balloon-assisted enteroscopy on the diagnosis and management of suspected and established small-bowel Crohn's disease CONCLUSIONS: The use of BAE may help improve management in patients with suspected and established small-bowel CD. 7/3/2015
Ahmed Abd El Wahed, Pranav Patel, Oumar Faye, Sasikanya Thaloengsok, Doris Heidenreich, Ponpan Matangkasombut, Khajohnpong Manopwisedjaroen, Anavaj Sakuntabhai, Amadou A Sall, Frank T Hufert, Manfred Weidmann Recombinase Polymerase Amplification Assay for Rapid Diagnostics of Dengue Infection CONCLUSIONS/SIGNIFICANCE: During the first 5 days of infection, the developed DENV1-4 RT-RPA assays constitute a suitable accurate and rapid assay for DENV diagnosis. Moreover, the use of a portable fluorescence-reading device broadens its application potential to the point-of-care for outbreak inve... 6/16/2015
Sergejs Nikisins, Toni Rieger, Pranav Patel, Rolf Müller, Stephan Günther, Matthias Niedrig International external quality assessment study for molecular detection of Lassa virus Lassa virus (LASV) is a causative agent of hemorrhagic fever in West Africa. In recent years, it has been imported several times to Europe and North America. The method of choice for early detection of LASV in blood is RT-PCR. Therefore, the European Network for Diagnostics of 'Imported' Viral Disea... 5/22/2015
Zubin Arora, Xianrui Wu, Udayakumar Navaneethan, Bo Shen Non-surgical porto-mesenteric vein thrombosis is associated with worse long-term outcomes in inflammatory bowel diseases CONCLUSIONS: IBD patients who were inpatients or receiving corticosteroid therapy had an increased risk of the development of PMVT. The presence of PMVT was associated with poor clinical outcomes in IBD. 4/30/2015
Paresh Dave, Bhavin Vadera, Ajay M V Kumar, Palanivel Chinnakali, Bhavesh Modi, Rajesh Solanki, Pranav Patel, Prakash Patel, Kirit Pujara, Pankaj Nimavat, Amar Shah, Sandeep Bharaswadkar, Kiran Rade, Malik Parmar, Sreenivas Achuthan Nair Has introduction of rapid drug susceptibility testing at diagnosis impacted treatment outcomes among previously treated tuberculosis patients in Gujarat, India? CONCLUSION: Offering DST at diagnosis improved the treatment outcomes among PT patients. However, even among tested, treatment outcomes remained suboptimal and were related to INH resistance and high loss-to-follow-up. These need to be addressed urgently for further progress. 4/16/2015
Udayakumar Navaneethan, Tarun Rai, Preethi Gk Venkatesh, Ravi P Kiran Primary sclerosing cholangitis and the risk of colon neoplasia in patients with Crohn's colitis CONCLUSIONS: CC patients with PSC appear not to be at increased risk of developing colon neoplasia. Among patients in our cohort with colon neoplasia and concurrent PSC, the neoplasia occurred in the proximal colon in all cases. 3/1/2015
Tarun Rai, Udayakumar Navaneethan, Tushar Gohel, Amareshwar Podugu, Prashanthi N Thota, Ravi P Kiran, Rocio Lopez, Madhusudhan R Sanaka Effect of quality of bowel preparation on quality indicators of adenoma detection rates and colonoscopy completion rates CONCLUSIONS: Patients with fair and poor standards of preparation have significantly lower colonoscopy completion rates than those with excellent and good preparation. However, there was no difference in ADR between the different grades of preparation. 2/15/2015
Gursimran Singh Kochhar, Udayakumar Navaneethan, Jason Hartman, Jose Mari Parungao, Rocio Lopez, Ranjan Gupta, Baljendra Kapoor, Paresh Mehta, Madhu Sanaka Comparative study of endoscopy vs. transjugular intrahepatic portosystemic shunt in the management of gastric variceal bleeding CONCLUSION: These findings suggest that both treatments are equally effective. Cyanoacrylate offers a safe, effective alternative to TIPS for gastric varices, and physician may choose the best therapy for each patient, factoring in the availability of TIPS or cyanoacrylate, the individual patient's ... 2/13/2015
Gursimran Kochhar, Udayakumar Navaneethan, Jose Mari Parungao, Jason Hartman, Ranjan Gupta, Rocio Lopez, Arthur J McCullough, Baljiendra Kapoor, Bo Shen Impact of transjugular intrahepatic portosystemic shunt on post-colectomy complications in patients with ulcerative colitis and primary sclerosing cholangitis CONCLUSION: Patients with PSC and UC who underwent TIPS prior to colectomy had higher rates of complications; however, this was probably due to the greater severity of cirrhosis and PSC in this population. 12/19/2014
Udayakumar Navaneethan, Norma G Gutierrez, Ramprasad Jegadeesan, Preethi Gk Venkatesh, Earl Poptic, Madhusudhan R Sanaka, John J Vargo, Mansour A Parsi IgG4 Levels in Bile for Distinguishing IgG4-Associated Cholangiopathy from Other Biliary Disorders: A Single Blinded Pilot Study CONCLUSIONS: The results of this pilot study suggest that measurement of biliary IgG4 levels may have clinical value in distinguishing patients with IAC from biliary disorders that can mimic IAC. 12/16/2014
Dhara Chaudhari, Atif Saleem, Pranav Patel, Sara Khan, Mark Young, Gene LeSage Hepatic artery mycotic aneurysm associated with staphylococcal endocarditis with successful treatment: case report with review of the literature Mycotic hepatic artery aneurysm is a vascular pathology associated with bacterial endocarditis. It is rare in occurrence after the introduction of effective antibiotics. We present a young patient with injection drug abuse associated staphylococcal endocarditis which was successfully treated with an... 11/8/2014
Udayakumar Navaneethan, Preethi Gk Venkatesh, Ramprasad Jegadeesan, Vennisvasanth Lourdusamy, Jeffrey P Hammel, Ravi P Kiran, Bo Shen Comparison of outcomes for patients with primary sclerosing cholangitis associated with ulcerative colitis and Crohn's disease CONCLUSIONS: PSC patients with CD appear to be associated with a lower risk of colon neoplasia and colectomy than PSC patients with UC. 10/31/2014
Arvind Murali Mohan, Kyle J Bibby, Daniel Lipus, Richard W Hammack, Kelvin B Gregory The functional potential of microbial communities in hydraulic fracturing source water and produced water from natural gas extraction characterized by metagenomic sequencing Microbial activity in produced water from hydraulic fracturing operations can lead to undesired environmental impacts and increase gas production costs. However, the metabolic profile of these microbial communities is not well understood. Here, for the first time, we present results from a shotgun m... 10/23/2014
Ji Young Bang, Shyam Varadarajulu Endoscopic ultrasound-guided management of pancreatic pseudocysts and walled-off necrosis The outcome of endoscopic management of pancreatic fluid collections is dependent on the type of collection being treated. While pseudocysts have an excellent treatment response, the outcomes are modest for walled-off pancreatic necrosis. Recent advances in cross-sectional body imaging have enabled ... 10/18/2014
Ji Young Bang, Shyam Varadarajulu Neoplasia in chronic pancreatitis: how to maximize the yield of endoscopic ultrasound-guided fine needle aspiration When performing endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), identifying neoplasia in the setting of chronic pancreatitis can be technically challenging. The morphology of an ill-defined mass on sonography, presence of calcifications or intervening collaterals, reverberation from a... 10/18/2014
Udayakumar Navaneethan, Vennisvasanth Lourdusamy, Preethi Gk Venkatesh, Belinda Willard, Madhusudhan R Sanaka, Mansour A Parsi Bile proteomics for differentiation of malignant from benign biliary strictures: a pilot study CONCLUSIONS: Protein biomarkers in bile may differentiate malignant from benign biliary strictures. Larger studies are warranted to validate these observations. 10/12/2014
Jayapal Ramesh, Ji Young Bang, Shantel Hebert-Magee, Jessica Trevino, Isam Eltoum, Andra Frost, Muhammad K Hasan, Amy Logue, Robert Hawes, Shyam Varadarajulu Randomized Trial Comparing the Flexible 19G and 25G Needles for Endoscopic Ultrasound-Guided Fine Needle Aspiration of Solid Pancreatic Mass Lesions CONCLUSIONS: As there is no significant difference in the performance of flexible 19G and 25G needles, needle choice for sampling pancreatic masses should be based on endoscopist preference and need for histology. 9/19/2014
Udayakumar Navaneethan, Basile Njei, Preethi Gk Venkatesh, Vennisvasanth Lourdusamy, Madhusudhan R Sanaka Endoscopic ultrasound in the diagnosis of cholangiocarcinoma as the etiology of biliary strictures: a systematic review and meta-analysis CONCLUSIONS: Our study suggests that EUS-FNA is useful in the evaluation of CCA as the etiology of biliary strictures. EUS-FNA may improve the diagnosis of CCA in patients with negative cytology and no mass on cross-sectional imaging. 8/30/2014
Arun Kannan, Chithra Poongkunran, Mahendran Jayaraj, Rajesh Janardhanan Role of strain imaging in right heart disease: a comprehensive review Advances in the imaging techniques of the heart have fueled the interest in understanding of right heart pathology. Recently, speckle tracking echocardiography has shown to aid in understanding various right heart diseases and better management. Its role is well established in diagnosing right heart... 8/12/2014
Jayapal Ramesh, Nipun Reddy, Hwasoon Kim, Klaus Mönkemüller, Shyam Varadarajulu, Brendan McGuire, Derek DuBay, Devin Eckhoff, C Mel Wilcox Safety and yield of diagnostic ERCP in liver transplant patients with abnormal liver function tests Background. Abnormal liver enzymes postorthotopic liver transplant (OLT) may indicate significant biliary pathology or organ rejection. There is very little known in the literature regarding the current role of diagnostic ERCP in this scenario. Aim. To review the utility of diagnostic ERCP in patien... 8/12/2014
Bronte A Holt, Shyam Varadarajulu, Shantel Hébert-Magee High-quality endoscopic ultrasound-guided fine needle aspiration tissue acquisition Endoscopic ultrasound-guided fine needle aspiration is a multistep procedure that involves proper clinical indication, correct selection of needles, adapting evidence-based techniques such as the fanning maneuver and not routinely using suction or the stylet for tissue sampling, and establishing rel... 6/25/2014
Udayakumar Navaneethan Hepatobiliary manifestations of ulcerative colitis: an example of gut-liver crosstalk The interaction between inflammatory bowel disease (IBD) and hepatobiliary manifestations represents a classic example of liver-gut crosstalk. The importance of liver-gut crosstalk in IBD is demonstrated in the pathogenesis and outcome of primary sclerosing cholangitis (PSC) in IBD patients. Immunog... 6/22/2014
Camille Escadafal, Oumar Faye, Amadou Alpha Sall, Ousmane Faye, Manfred Weidmann, Oliver Strohmeier, Felix von Stetten, Josef Drexler, Michael Eberhard, Matthias Niedrig, Pranav Patel Rapid molecular assays for the detection of yellow fever virus in low-resource settings CONCLUSION/SIGNIFICANCE: The assay was able to detect 20 different YFV strains and demonstrated no cross-reactions with closely related viruses. The RPA assay proved to be a robust, portable method with a low detection limit (<21 genome equivalent copies per reaction) and rapid processing time (<20 ... 3/8/2014
Neeraj Raizada, K S Sachdeva, D S Chauhan, Bharti Malhotra, Kishore Reddy, P V Dave, Yamuna Mundade, Pranav Patel, Ranjani Ramachandran, Ram Das, Rajesh Solanki, Douglas Fraser Wares, Suvanand Sahu, Rick O'Brien, C N Paramasivan, Puneet K Dewan A multi-site validation in India of the line probe assay for the rapid diagnosis of multi-drug resistant tuberculosis directly from sputum specimens CONCLUSIONS: LPA proved highly accurate in the rapid detection of R resistance. The reduction in time to diagnosis may potentially enable earlier commencement of the appropriate drug therapy, leading to some reduction of transmission of drug-resistant strains. 3/4/2014
Ahmed Abd El Wahed, Pranav Patel, Doris Heidenreich, Frank T Hufert, Manfred Weidmann Reverse transcription recombinase polymerase amplification assay for the detection of middle East respiratory syndrome coronavirus The emergence of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the eastern Mediterranean and imported cases to Europe has alerted public health authorities. Currently, detection of MERS-CoV in patient samples is done by real-time RT-PCR. Samples collected from suspected cases are sent t... 1/25/2014
Ji Young Bang, Shyam Varadarajulu Procore and flexible 19 gauge needle can replace trucut biopsy needle? Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is routinely performed for establishing tissue diagnosis in patients with gastrointestinal tumors. The concept of delivering chemotherapy based on molecular markers and the ability to establish a reliable diagnosis in lieu of an onsite cy... 10/22/2013
Ji Young Bang, Shyam Varadarajulu Metal versus Plastic Stent for Transmural Drainage of Pancreatic Fluid Collections The conventional management of pancreatic fluid collections (PFCs) involves surgery or percutaneous drainage. While surgery is associated with significant complications and mortality, percutaneous drainage is associated with prolonged hospitalization and oftentimes the need for other adjunctive trea... 10/22/2013
Pranav V Patel, Hitesh K Patel, Shital S Panchal, Tejal A Mehta Self micro-emulsifying drug delivery system of tacrolimus: Formulation, in vitro evaluation and stability studies CONCLUSIONS: The results indicate that liquid SMEDDS and solid SMEDDS of tacrolimus, owing to nano-sized, have potential to enhance the absorption of the drug. 9/10/2013
Danny Estupinan, Sunina Nathoo, Michael S Okun The Demise of Poskanzer and Schwab's Influenza Theory on the Pathogenesis of Parkinson's Disease In 1961, David C. Poskanzer and Robert S. Schwab presented a paper, "Studies in the epidemiology of Parkinson's disease predicting its disappearance as a major clinical entity by 1980." This paper introduced the hypothesis that Parkinson's disease was derived from a single aetiology, the influenza v... 7/16/2013
Camille Escadafal, Janusz T Paweska, Antoinette Grobbelaar, Chantel le Roux, Michèle Bouloy, Pranav Patel, Anette Teichmann, Oliver Donoso-Mantke, Matthias Niedrig International external quality assessment of molecular detection of Rift Valley fever virus Rift Valley fever (RVF) is a viral zoonosis that primarily affects animals resulting in considerable economic losses due to death and abortions among infected livestock. RVF also affects humans with clinical symptoms ranging from an influenza-like illness to a hemorrhagic fever. Over the past years,... 5/30/2013
Pranav Patel, Hitesh Patel, Shital Panchal, Tejal Mehta Formulation strategies for drug delivery of tacrolimus: An overview Tacrolimus (FK 506) is a potent macrolide lactone immunosuppressive agent used for prophylaxis of organ rejection after transplantation and graft-versus-host disease after bone marrow transplantation in patients. Moreover, tacrolimus is a drug of choice in the treatment of atopic dermatitis for decr... 4/13/2013
Madeline Vargas, Nikhil S Malvankar, Pier-Luc Tremblay, Ching Leang, Jessica A Smith, Pranav Patel, Oona Snoeyenbos-West, Kelly P Nevin, Derek R Lovley Aromatic amino acids required for pili conductivity and long-range extracellular electron transport in Geobacter sulfurreducens It has been proposed that Geobacter sulfurreducens requires conductive pili for long-range electron transport to Fe(III) oxides and for high-density current production in microbial fuel cells. In order to investigate this further, we constructed a strain of G. sulfurreducens, designated Aro-5, which... 3/14/2013
Parag Brahmbhatt, Pranav Patel, Atif Saleem, Rathi Narayan, Mark Young Retroperitoneal paraganglioma presenting as a chest pain: a case report Paragangliomas are very rare tumors derived from neuroendocrine cells of autonomic nervous system. Extra-adrenal paragangliomas account for only 10 to 15% of all paragangliomas and may present incidentally as a mass. Typical triad of fluctuating hypertension, headache, and sweating is not always pre... 2/21/2013
Pranav Patel, Olfert Landt, Marco Kaiser, Oumar Faye, Tanja Koppe, Ulrich Lass, Amadou A Sall, Matthias Niedrig Development of one-step quantitative reverse transcription PCR for the rapid detection of flaviviruses CONCLUSION: The assay is rapid, broad-range flavivirus-specific and highly sensitive making it a valuable tool for rapid detection of flaviviruses in livestock samples, epidemiological studies or as useful complement to single flavivirus-specific assays for clinical diagnosis. 2/16/2013
David C Whitcomb, Jessica LaRusch, Alyssa M Krasinskas, Lambertus Klei, Jill P Smith, Randall E Brand, John P Neoptolemos, Markus M Lerch, Matt Tector, Bimaljit S Sandhu, Nalini M Guda, Lidiya Orlichenko, Alzheimer's Disease Genetics Consortium, Samer Alkaade, Stephen T Amann, Michelle A Anderson, John Baillie, Peter A Banks, Darwin Conwell, Gregory A Coté, Peter B Cotton, James DiSario, Lindsay A Farrer, Chris E Forsmark, Marianne Johnstone, Timothy B Gardner, Andres Gelrud, William Greenhalf, Jonathan L Haines, Douglas J Hartman, Robert A Hawes, Christopher Lawrence, Michele Lewis, Julia Mayerle, Richard Mayeux, Nadine M Melhem, Mary E Money, Thiruvengadam Muniraj, Georgios I Papachristou, Margaret A Pericak-Vance, Joseph Romagnuolo, Gerard D Schellenberg, Stuart Sherman, Peter Simon, Vijay P Singh, Adam Slivka, Donna Stolz, Robert Sutton, Frank Ulrich Weiss, C Mel Wilcox, Narcis Octavian Zarnescu, Stephen R Wisniewski, Michael R O'Connell, Michelle L Kienholz, Kathryn Roeder, M Michael Barmada, Dhiraj Yadav, Bernie Devlin Common genetic variants in the CLDN2 and PRSS1-PRSS2 loci alter risk for alcohol-related and sporadic pancreatitis Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report ... 11/13/2012
Jayapal Ramesh, Shyam Varadarajulu How can we get the best results with endoscopic ultrasound-guided fine needle aspiration? Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has evolved to become an indispensable tool for tissue acquisition. While the overall diagnostic accuracy of EUS-FNA is greater than 90% for lung cancer staging, it is lower for pancreatic mass lesions. Several factors such as location of... 8/7/2012
Robert H Hawes, James Clancy, Muhammad K Hasan Endoscopic ultrasound-guided fine needle aspiration in cystic pancreatic lesions Incidental pancreatic cysts are being increasingly recognized recently with incremented concern about health and frequent health check-up. Endoscopic ultrasound (EUS) has emerged as the principal modality for imaging pancreas for various pancreatic diseases including pancreatic cyst. But imaging alo... 8/7/2012
Rajesh A Keraliya, Chirag Patel, Pranav Patel, Vipul Keraliya, Tejal G Soni, Rajnikant C Patel, M M Patel Osmotic drug delivery system as a part of modified release dosage form Conventional drug delivery systems are known to provide an immediate release of drug, in which one can not control the release of the drug and can not maintain effective concentration at the target site for longer time. Controlled drug delivery systems offer spatial control over the drug release. Os... 8/2/2012
Uday R Deotare, Pranav D Patel, Rohan P Parikh, Eva A Bhagat Uncommon cause of recurrent infections We descibe the case of a girl of Indian origin who presented with recurrent infections. The only abnormality detected in the armoury of the immune system was consistent neutropenia. Mutation analysis revealed ELA2 (neutrophil elastase) gene mutation that has been associated with severe congenital ne... 7/4/2012
Ann Roy, Micheline Kim, John Christein, Shyam Varadarajulu Stenting versus gastrojejunostomy for management of malignant gastric outlet obstruction: comparison of clinical outcomes and costs CONCLUSIONS: While the technical and clinical outcomes of surgical GJ and endoscopic stenting appear comparable, stent placement is less costly and is associated with shorter length of hospital stay. Dissemination of endoscopic stenting beyond teaching, academic hospitals located in urban areas as a... 5/3/2012
Pranav H Patel, Alistair Ap Slesser, Aoff Khalil, Oliver Bassett, Kt Natarajan, Jeremy I Livingstone A rare case of small bowel volvulus after jenjunoileal bariatric bypass requiring emergency surgery: a case report CONCLUSIONS: Bariatric surgery may be complicated by bowel obstruction. Early imaging is vital for diagnosis and effective management. The use of our surgical technique provides a simple and effective approach for the successful management of this bariatric complication. 3/9/2012
Varun Vaidya, Pranav Patel Health expenditure comparison of extended-release metoprolol succinate and immediate-release metoprolol tartarate CONCLUSION: Both the products of metoprolol were found to have similar average annual total health care expenditure; however, MS once a day has higher out-of-pocket cost. 2/24/2012
Christopher Decker, John D Christein, Milind A Phadnis, C Mel Wilcox, Shyam Varadarajulu Biliary metal stents are superior to plastic stents for preoperative biliary decompression in pancreatic cancer CONCLUSIONS: SEMS are superior to plastic stents for preoperative biliary decompression in pancreatic cancer. 3/5/2011
Shyam Varadarajulu, Ann Roy, Tercio Lopes, Ernesto R Drelichman, Micheline Kim Endoscopic stenting versus surgical colostomy for the management of malignant colonic obstruction: comparison of hospital costs and clinical outcomes CONCLUSION: Although the technical and clinical outcomes for colostomy and stent placement appear comparable, stent placement is less costly and associated with shorter LOS and fewer complications. Dissemination of stent placement beyond large teaching hospitals located in urban areas as a treatment... 2/5/2011
Udayakumar Navaneethan, Jijo V Cherian, Rajesh Prabhu, Jayanthi Venkataraman Distinguishing tuberculosis and Crohn's disease in developing countries: how certain can you be of the diagnosis? Distinguishing tuberculosis and Crohn's disease in patients presenting with chronic abdominal pain and diarrhea is a huge diagnostic challenge, particularly in tuberculosis endemic countries. A large number of patients with Crohn's disease are initially misclassified as having Intestinal tuberculosi... 7/2/2009
Udayakumar Navaneethan, Ralph A Giannella Thinking beyond the colon-small bowel involvement in clostridium difficile infection Small intestinal Clostridium difficile seems to be increasing in incidence. The spectrum of Clostridium difficile infection (CDI) has definitely expanded with small bowel involvement. They are more frequently reported in patients with inflammatory bowel disease (IBD) who have undergone total colecto... 4/3/2009
Regina S Meara, Vishnu Reddy, Juan Pablo Arnoletti, Darshana Jhala, Shyam Varadarajulu, Nirag Jhala Hairy cell leukemia: a diagnosis by endoscopic ultrasound guided fine needle aspiration CONCLUSION: This report underscores the concept that the presence of a cytopathologist in the endoscopy suite plays an important role in providing accurate diagnoses of lymphoid lesions biopsied with EUS-FNA. 1/25/2006