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Herman T, Wilson N, Wongjarupong N, Megna B, Are V, Lou S, Bilal M, Hanson B. An intraprocedural cleansing system to improve inadequate bowel preparation during colonoscopy. VideoGIE 2024; 9:179-181. [PMID: 38618617 PMCID: PMC11009472 DOI: 10.1016/j.vgie.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Affiliation(s)
- Tessa Herman
- Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Natalie Wilson
- Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Nicha Wongjarupong
- Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Bryant Megna
- Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Vijay Are
- Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Susan Lou
- Gastroenterology Section, Minneapolis VA Medical Center, Minneapolis, Minnesota
| | - Mohammad Bilal
- Gastroenterology Section, Minneapolis VA Medical Center, Minneapolis, Minnesota
| | - Brian Hanson
- Gastroenterology Section, Minneapolis VA Medical Center, Minneapolis, Minnesota
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Hirsch W, Megna B, Adeyi O, Lim N. Macrophage activation syndrome with acute hepatitis in a patient with adult-onset immunodeficiency with anti-interferon gamma antibodies: a case report. J Med Case Rep 2024; 18:6. [PMID: 38178160 PMCID: PMC10768153 DOI: 10.1186/s13256-023-04245-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/05/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Macrophage activation syndrome is a rare disorder leading to unregulated immune activity manifesting with nonspecific constitutional symptoms, laboratory abnormalities, and multiorgan involvement. We report the case of a patient who presented with acute hepatitis secondary to macrophage activation syndrome diagnosed by liver biopsy and successfully treated with intravenous immune globulin, anakinra, and rituximab. CASE PRESENTATION A 42-year-old Laotian woman with adult-onset immunodeficiency with anti-interferon gamma antibodies presented with a fever, headache, generalized myalgia, dark urine, and reduced appetite in the setting of family members at home with similar symptoms. Her laboratory workup was notable for evidence of acute hepatitis without acute liver failure. After an unrevealing comprehensive infectious and noninvasive rheumatologic workup was completed, a liver biopsy was performed ultimately revealing the diagnosis of macrophage activation syndrome. She was successfully treated with intravenous immune globulin, anakinra, and rituximab. CONCLUSION This case highlights the importance of maintaining macrophage activation syndrome on the differential of a patient with acute hepatitis of unknown etiology in the correct clinical context and the value of a liver biopsy in making a diagnosis when noninvasive testing is unrevealing.
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Affiliation(s)
- William Hirsch
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
| | - Bryant Megna
- Division of Gastroenterology, Hepatology, & Nutrition, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Oyedele Adeyi
- Department of Laboratory Medicine & Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Nicholas Lim
- Division of Gastroenterology, Hepatology, & Nutrition, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
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Herman T, Megna B, Pallav K, Bilal M. Endoscopic mucosal resection: tips and tricks for gastrointestinal trainees. Transl Gastroenterol Hepatol 2023; 8:25. [PMID: 37601741 PMCID: PMC10432230 DOI: 10.21037/tgh-23-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/15/2023] [Indexed: 08/22/2023] Open
Abstract
Endoscopic mucosal resection (EMR) is a minimally invasive, specialized endoscopic technique that is useful in resecting superficial gastrointestinal lesions that are unable to be removed by standard polypectomy. This is typically accomplished using a submucosal injection that lifts the lesion away from the muscularis propria to allow for safe resection of the polyp, either via piecemeal or en bloc resection. Over the years, several techniques exist to perform EMR including conventional EMR or hot EMR, cold EMR and underwater EMR. Despite its established advantages and safety over conventional techniques such as surgery, the adoption of endoscopic resection (and thus the education and training of gastroenterology trainees) is lagging. The goal of this article is to offer a comprehensive review of the basic principles of colonic EMR. We review the concepts of optical diagnosis including the various polyp classification systems available to determine the polyp morphology and histology. We also discuss the technical aspects of performing colonic EMR. We also outline the common adverse events associated with EMR including bleeding, perforation, postpolypectomy syndrome, and residual or recurrent polyps, and discuss preventative measures that can be taken to mitigate adverse events. Lastly, we offer practical tips for trainees who want to undertake EMR in their clinical practice.
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Affiliation(s)
- Tessa Herman
- Department of Internal Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Bryant Megna
- Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, MN, USA
| | - Kumar Pallav
- Division of Gastroenterology & Hepatology, The University of Texas Medical Branch, Galveston, TX, USA
| | - Mohammad Bilal
- Advanced Endoscopy, Division of Gastroenterology & Hepatology, Minneapolis Veterans Affairs Health Care System, University of Minnesota, Minneapolis, MN, USA
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Andreone M, Megna B, McDonald N, Sunjaya D, Hanson B, Bilal M. Use of Endoscopic Suturing for the Treatment of Malignant Gastric Ulcer-Related Hemorrhage. ACG Case Rep J 2023; 10:e01047. [PMID: 37180465 PMCID: PMC10171711 DOI: 10.14309/crj.0000000000001047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
Gastrointestinal bleeding secondary to malignancy can be difficult to manage with traditional endoscopic therapies. Endoscopic suturing is a relatively new technology with limited data available regarding its use for bleeding related to peptic ulcer disease. We describe a case where endoscopic suturing was successfully used to control gastrointestinal hemorrhage from a previously known malignant ulceration that was refractory to traditional interventions.
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Affiliation(s)
- Michael Andreone
- Department of Internal Medicine, University of Minnesota, Minneapolis, MN
| | - Bryant Megna
- Division of Gastroenterology and Hepatology, University of Minnesota Medical Center, Minneapolis, MN
| | - Nicholas McDonald
- Division of Gastroenterology and Hepatology, University of Minnesota Medical Center, Minneapolis, MN
| | - Dharma Sunjaya
- Department of Gastroenterology and Hepatology, Minneapolis VA Medical Center, University of Minnesota, Minneapolis, MN
| | - Brian Hanson
- Department of Gastroenterology and Hepatology, Minneapolis VA Medical Center, University of Minnesota, Minneapolis, MN
| | - Mohammad Bilal
- Division of Gastroenterology and Hepatology, University of Minnesota Medical Center, Minneapolis, MN
- Department of Gastroenterology and Hepatology, Minneapolis VA Medical Center, University of Minnesota, Minneapolis, MN
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Wilson N, McDonald N, Megna B, Abdallah M, Bilal M. Duodenal stent fixation using through-the-scope helix tack and suture device. Endoscopy 2022; 55:E102-E103. [PMID: 36241182 PMCID: PMC9829776 DOI: 10.1055/a-1944-9018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Natalie Wilson
- University of Minnesota Medical Center, Department of Internal Medicine, Minneapolis, MN, USA
| | - Nicholas McDonald
- University of Minnesota Medical Center, Division of Gastroenterology and Hepatology Minneapolis, MN, USA
| | - Bryant Megna
- University of Minnesota Medical Center, Division of Gastroenterology and Hepatology Minneapolis, MN, USA
| | - Mohamed Abdallah
- University of Minnesota Medical Center, Division of Gastroenterology and Hepatology Minneapolis, MN, USA
| | - Mohammad Bilal
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
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Angeli AM, Megna B, Mazepa M, Ivy ZK, Sultan S, Sloan JA. Transfusion-dependent anemia secondary to vitamin C deficiency. Am J Hematol 2022; 97:E166-E167. [PMID: 35108411 PMCID: PMC8986622 DOI: 10.1002/ajh.26484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 11/08/2022]
Affiliation(s)
| | - Bryant Megna
- Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition University of Minnesota Minneapolis Minnesota USA
| | - Marshall Mazepa
- Department of Medicine, Division of Hematology, Oncology, and Transplantation University of Minnesota Minneapolis Minnesota USA
| | - Zalaya K. Ivy
- Department of Medicine, Division of Hematology, Oncology, and Transplantation University of Minnesota Minneapolis Minnesota USA
| | - Shahnaz Sultan
- Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition University of Minnesota Minneapolis Minnesota USA
| | - Joshua A. Sloan
- Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition University of Minnesota Minneapolis Minnesota USA
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Affiliation(s)
- Bryant Megna
- Department of Medicine and the Minneapolis Veterans Affairs Medical Center, Section of Gastroenterology, University of Minnesota, Minneapolis, MN, USA
| | - Aasma Shaukat
- Department of Medicine and the Minneapolis Veterans Affairs Medical Center, Section of Gastroenterology, University of Minnesota, Minneapolis, MN, USA
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Hubers J, Patel R, Dalvie P, Megna B, Gopal D. Percutaneous transhepatic cholangioscopy with electrohydraulic lithotripsy in a patient with choledocholithiasis complicating a benign stricture. VideoGIE 2019; 4:423-425. [PMID: 31517169 PMCID: PMC6728896 DOI: 10.1016/j.vgie.2019.04.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Jeffrey Hubers
- Division of Gastroenterology & Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Ravi Patel
- Division of Gastroenterology & Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | | | - Bryant Megna
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Deepak Gopal
- Division of Gastroenterology & Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Megna B, Weiss J, Ley D, Saha S, Pfau P, Grimes I, Li Z, Caldera F. Clear liquid diet before bowel preparation predicts successful chromoendoscopy in patients with inflammatory bowel disease. Gastrointest Endosc 2019; 89:373-379.e2. [PMID: 30339950 DOI: 10.1016/j.gie.2018.09.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 09/29/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Chromoendoscopy (CE) has been shown to generate both a superior diagnostic yield and dysplasia detection rate than conventional white-light endoscopy and requires a high-quality bowel preparation. The aim of this study was to identify predictors of the ability to perform CE in patients with inflammatory bowel disease (IBD). METHODS We performed an observational study of patients with IBD undergoing colorectal cancer surveillance examinations with CE. Same-day colonoscopy surveys were used to collect patient and procedural variables. Multivariate logistic regression was used to establish odds ratios of successful completion of CE. RESULTS Eighty-eight patients with IBD were enrolled. We found that patients who did not follow a clear liquid diet before colonoscopy had much lower odds of being able to undergo CE (odds ratio, 0.106; 95% confidence interval, 0.013-0.845; P < .034). Further, we found that previously identified risk factors (older age, history of diabetes mellitus, the timing and split dosing of preparation solution, and procedure time (AM or PM), chronic narcotic use, and history of constipation) for inadequate bowel preparation were not associated with the ability to perform CE. CONCLUSIONS Following a clear liquid diet the entire day before the procedure was highly predictive of the ability to perform CE. However, established risk factors for inadequate bowel preparation did not inhibit the ability to perform CE in our population. Endoscopists performing CE should consider recommending that patients follow a clear liquid diet the entire day before their examination.
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Affiliation(s)
- Bryant Megna
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Jennifer Weiss
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin, Madison, Wisconsin, USA
| | - Dana Ley
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Sumona Saha
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin, Madison, Wisconsin, USA
| | - Patrick Pfau
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin, Madison, Wisconsin, USA
| | - Ian Grimes
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin, Madison, Wisconsin, USA
| | - Zhanhai Li
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, USA
| | - Freddy Caldera
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin, Madison, Wisconsin, USA
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Caldera F, Misch EA, Saha S, Wald A, Zhang Y, Hubers J, Megna B, Ley D, Reichelderfer M, Hayney MS. Immunosuppression Does Not Affect Antibody Concentrations to Measles, Mumps, and Rubella in Patients with Inflammatory Bowel Disease. Dig Dis Sci 2019; 64:189-195. [PMID: 30317494 DOI: 10.1007/s10620-018-5321-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 10/03/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND The Advisory Committee on Immunization Practices (ACIP) recommends using the immunization record and not serologic testing to determine immunity against measles and rubella in the general population, due to potential false negatives. However, it is unknown whether the immune response is less durable among patients who are immunosuppressed. AIMS The primary aim of this study was to evaluate sustained vaccine-induced measles, mumps, and rubella (MMR) antibody concentrations in immunosuppressed patients with inflammatory bowel disease (IBD). METHODS We performed a cross-sectional study to compare antibody concentrations following the two-dose (MMR) vaccine among 46 patients with IBD and 20 healthy controls (HC). Three IBD groups stratified by the immunosuppressive regimen that preceded study entry for at least 3 months: (1) thiopurine monotherapy, (2) anti-TNF monotherapy, or (3) combination therapy (anti-TNF agent combined with an immunomodulator) were enrolled. RESULTS All subjects had measurable antibody concentrations to the three vaccine viruses. Age and time since receipt of MMR series were similar in both groups. There were no difference in the antibody concentration of measles (IBD 667 mIU/ml vs HC 744 mIU/ml; p = 0.45), mumps (IBD 339 EU/ml vs HC 402 EU/ml; p = 0.62), or rubella (IBD 25 mIU/ml vs HC 62 mIU/ml; p = 0.11) among the groups. No differences in antibody concentrations were found among the IBD treatment groups. CONCLUSION Immunosuppressed patients with IBD have sustained antibody concentrations comparable to healthy controls. Thus, gastroenterologist should follow the ACIP recommendations and use the immunization record when available to determine immunity to measles and rubella in patients with IBD. Clinical Trials Registry # NCT02434133.
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Affiliation(s)
- Freddy Caldera
- Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin-Madison, 1685 Highland Avenue, Madison, WI, 53705-2281, USA.
| | - Elizabeth Ann Misch
- Department of Medicine, Division of Infectious Disease, School of Medicine and Public Health, University of Wisconsin-Madison, 1685 Highland Avenue, Madison, WI, 53705-2281, USA
| | - Sumona Saha
- Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin-Madison, 1685 Highland Avenue, Madison, WI, 53705-2281, USA
| | - Arnold Wald
- Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin-Madison, 1685 Highland Avenue, Madison, WI, 53705-2281, USA
| | - Youqi Zhang
- School of Pharmacy, School of Medicine and Public Health, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI, 53705, USA
| | - Jeffrey Hubers
- Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin-Madison, 1685 Highland Avenue, Madison, WI, 53705-2281, USA
| | - Bryant Megna
- School of Medicine and Public Health, University of Wisconsin-Madison, 750 Highland Avenue, Madison, WI, 53705, USA
| | - Dana Ley
- School of Medicine and Public Health, University of Wisconsin-Madison, 750 Highland Avenue, Madison, WI, 53705, USA
| | - Mark Reichelderfer
- Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin-Madison, 1685 Highland Avenue, Madison, WI, 53705-2281, USA
| | - Mary S Hayney
- School of Pharmacy, School of Medicine and Public Health, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI, 53705, USA
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Caldera F, Saha S, Wald A, Garmoe CA, McCrone S, Megna B, Ley D, Reichelderfer M, Hayney MS. Lower Sustained Diphtheria and Pertussis Antibody Concentrations in Inflammatory Bowel Disease Patients. Dig Dis Sci 2018; 63:1532-1540. [PMID: 29594970 DOI: 10.1007/s10620-018-5043-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 03/23/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients with inflammatory bowel disease (IBD) are often immunosuppressed, and those patients receiving anti-tumor necrosis factor α (TNF) therapy can have lower antibody responses to vaccines. Pertussis cases are at their highest levels in the post-vaccine era. There is little data regarding responses to the Tdap (tetanus, diphtheria, and acellular pertussis) vaccine in IBD patients. AIMS The aim of this study was to compare sustained vaccine-induced Tdap antibody concentrations in a cohort of IBD patients stratified by medication regimens with healthy controls (HC) who had received an adult Tdap booster. METHODS We performed a cross-sectional study evaluating antibody responses to Tdap vaccine among IBD patients compared to HC. Our study consisted of three patient groups: adults with IBD stratified by maintenance medication regimen: (1) thiopurine monotherapy; (2) anti-TNF monotherapy; and (3) combination therapy (anti-TNF and immunomodulator (thiopurine or methotrexate)). RESULTS Ninety IBD patients and 20 HC participated. Pertussis pertactin antibody concentrations were significantly lower in IBD patients (p = 0.021) compared to HC, and those on anti-TNF agents (monotherapy or combination) had lower antibody concentrations compared to those on thiopurine monotherapy (p = 0.028). Diphtheria antibody concentrations were also lower in IBD patients (p < 0.001), and those on anti-TNF agents (monotherapy or combination) had lower antibody concentrations compared to the thiopurine monotherapy group (p < 0.001). CONCLUSION IBD patients on anti-TNF agents had lower antibody concentrations to diphtheria and pertussis. These findings suggest a need for different Tdap booster schedules for IBD patients on anti-TNF therapy. Clinical Trials Registry NCT02434133.
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Affiliation(s)
- Freddy Caldera
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705-2281, USA.
| | - Sumona Saha
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705-2281, USA
| | - Arnold Wald
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705-2281, USA
| | - Christine A Garmoe
- School of Pharmacy, University of Wisconsin, 777 Highland Ave., Madison, WI, 53705, USA
| | - Sue McCrone
- School of Pharmacy, University of Wisconsin, 777 Highland Ave., Madison, WI, 53705, USA
| | - Bryant Megna
- School of Medicine and Public Health, University of Wisconsin, 750 Highland Ave., Madison, WI, 53705, USA
| | - Dana Ley
- School of Medicine and Public Health, University of Wisconsin, 750 Highland Ave., Madison, WI, 53705, USA
| | - Mark Reichelderfer
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705-2281, USA
| | - Mary S Hayney
- School of Pharmacy, University of Wisconsin, 777 Highland Ave., Madison, WI, 53705, USA
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Megna B, Saha S, Wald A, Agni R, Matkowskyj KA, Caldera F. Symptomatic Microscopic Colitis Atop Quiescent Inflammatory Bowel Disease: A Case Series. ACG Case Rep J 2017; 4:e124. [PMID: 29299484 PMCID: PMC5741139 DOI: 10.14309/crj.2017.124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 10/10/2017] [Indexed: 12/23/2022] Open
Abstract
Microscopic colitis (MC) has rarely been described to be the cause of watery diarrhea in those with established inflammatory bowel disease (IBD), and instead has been presented as a herald syndrome to eventual IBD or incidentally found in asymptomatic IBD patients. We report a case series of 7 patients with IBD who presented with a watery diarrheal exacerbation due to new-onset MC. We propose that new-onset MC should be considered in the differential diagnosis of watery diarrhea occurring in patients with long-standing IBD and that evaluation should include colonoscopy with biopsies obtained throughout the colon.
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Affiliation(s)
- Bryant Megna
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin, Madison, WI
| | - Sumona Saha
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin, Madison, WI
| | - Arnold Wald
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin, Madison, WI
| | - Rashmi Agni
- Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison, WI
| | | | - Freddy Caldera
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Wisconsin, Madison, WI
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Bellardita M, García-López EI, Marcì G, Megna B, Pomilla FR, Palmisano L. Photocatalytic conversion of glucose in aqueous suspensions of heteropolyacid–TiO2 composites. RSC Adv 2015. [DOI: 10.1039/c5ra09894g] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Commercial and home prepared TiO2 samples were functionalized with a commercial Keggin heteropolyacid (HPA) H3PW12O40 (PW12) or with a hydrothermally home prepared K7PW11O39 salt (PW11).
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Affiliation(s)
- M. Bellardita
- Schiavello-Grillone” Photocatalysis Group
- Dipartimento di Energia
- Ingegneria dell'informazione
- e modelli Matematici (DEIM)
- Università degli Studi di Palermo
| | - E. I. García-López
- Schiavello-Grillone” Photocatalysis Group
- Dipartimento di Energia
- Ingegneria dell'informazione
- e modelli Matematici (DEIM)
- Università degli Studi di Palermo
| | - G. Marcì
- Schiavello-Grillone” Photocatalysis Group
- Dipartimento di Energia
- Ingegneria dell'informazione
- e modelli Matematici (DEIM)
- Università degli Studi di Palermo
| | - B. Megna
- Dipartimento Ingegneria Civile
- Ambientale, Aerospaziale, dei Materiali
- 90128 Palermo
- Italy
| | - F. R. Pomilla
- Schiavello-Grillone” Photocatalysis Group
- Dipartimento di Energia
- Ingegneria dell'informazione
- e modelli Matematici (DEIM)
- Università degli Studi di Palermo
| | - L. Palmisano
- Schiavello-Grillone” Photocatalysis Group
- Dipartimento di Energia
- Ingegneria dell'informazione
- e modelli Matematici (DEIM)
- Università degli Studi di Palermo
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