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Hernandez LV, Agrawal D, Skole KS, Crockett SD, Shimpi RA, von Renteln D, Pohl H. Meeting the environmental challenges of endoscopy: a pathway from strategy to implementation. Gastrointest Endosc 2023; 98:881-888.e1. [PMID: 37977670 DOI: 10.1016/j.gie.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Lyndon V Hernandez
- Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, Oregon, USA
| | - Deepak Agrawal
- Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina, USA
| | - Kevin S Skole
- Department of Gastroenterology, Penn Medicine Princeton Medical Center, Plainsboro, New Jersey, USA
| | | | - Rahul A Shimpi
- Division of Gastroenterology, Montreal University Hospital Center (CHUM) and Montreal University Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Daniel von Renteln
- Division of Gastroenterology and Hepatology, Dell Medical School, University Texas at Austin, Austin, Texas, USA
| | - Heiko Pohl
- Department of Gastroenterology, VA Medical Center, White River Junction, Vermont, USA; Department of Gastroenterology, VA Medical Center, White River Junction, Vermont; Dartmouth Hitchcock Medical Center, New Hampshire, USA
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Crockett SD, Skole KS, Hernandez LV, von Renteln D, Agrawal D, Pohl H, Shimpi RA. Practical steps to green your endoscopy unit: how to get started. Gastrointest Endosc 2023; 98:889-892.e1. [PMID: 37897445 DOI: 10.1016/j.gie.2023.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 10/30/2023]
Affiliation(s)
- Seth D Crockett
- Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, Oregon, USA
| | - Kevin S Skole
- Department of Gastroenterology, Penn Medicine Princeton Medical Center, Plainsboro, New Jersey, USA
| | | | - Daniel von Renteln
- Division of Gastroenterology, Montreal University Hospital Center (CHUM) and Montreal University Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Deepak Agrawal
- Division of Gastroenterology and Hepatology, Dell Medical School, University Texas at Austin, Austin, Texas, USA
| | - Heiko Pohl
- Division of Gastroenterology and Hepatology, Department of Gastroenterology, VA Medical Center, White River Junction, Vermont, USA; Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Rahul A Shimpi
- Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina, USA
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Tarangelo NP, Ha K, Skole KS. Duodenal Glomus Tumor: A Rare Cause of Upper GI Bleeding. Clin Gastroenterol Hepatol 2016; 14:e123-4. [PMID: 27033430 DOI: 10.1016/j.cgh.2016.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/09/2016] [Accepted: 03/18/2016] [Indexed: 02/07/2023]
Affiliation(s)
| | - Kai Ha
- Robert Wood Johnson University Hospital, New Brunswick, New Jersey
| | - Kevin S Skole
- University Medical Center at Princeton-Plainsboro, Plainsboro, New Jersey
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Friedenberg FK, Gollamudi SP, Chang AW, Guatam M, Schmutz JK, Skole KS, Thomas RM, Black M. Factors Associated with Ribavirin-Induced Anemia. J Pharm Technol 2005. [DOI: 10.1177/875512250502100405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: During treatment of hepatitis C, ribavirin-induced anemia (RIA) requires reduction of the ribavirin dose or initiation of erythropoietin in up to 20% of patients. RIA usually occurs in the first 8 weeks of treatment, and a decrease >3 g/dL or a nadir <10 g/dL is considered significant. Objective: To prospectively examine factors associated with RIA in a population of patients with hepatitis C. Methods: Consecutive patients with hepatitis C (hepatitis B virus and HIV negative) underwent treatment with pegylated interferon and weight-based ribavirin. Prospectively gathered data included demographics, alcohol consumption, and hepatitis C virus risk factors. Patients underwent laboratory studies at baseline and at intervals of 4–8 weeks after starting treatment. Results: One hundred eight patients were enrolled. Of these, 30 (27.8%) experienced a >3 g/dL fall in hemoglobin levels in the first 8 weeks; in 10 (33%) patients, the change occurred by week 4. The initial hemoglobin level was higher in those with a decrease compared with those without a fall (15.3 vs 14.1 g/dL; p < 0.001). In addition, for patients with a decrease, the iron saturation was higher (44.6% vs 30.1%; p = 0.002). Finally, those with fibrosis stage 6/6 (cirrhosis) had a greater percent fall in hemoglobin (27.0% vs 14.0%; p = 0.009) than those with less severe fibrosis. By logistic regression analysis, only iron saturation was associated with RIA (p = 0.002). Conclusions: In our patients, initial hemoglobin, serum iron, and fibrosis were associated with a potentially clinically important decrease in hemoglobin. In approximately one-third of the population, RIA occurred in the first 4 weeks of treatment. No patient had a severe complication.
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Affiliation(s)
- Frank K Friedenberg
- FRANK K FRIEDENBERG MD, Associate Professor of Medicine, Gastroenterology Section, Temple University Hospital, Philadelphia, PA
| | | | - Alan W Chang
- ALAN W CHANG MD, Gastroenterology Fellow, Temple University Hospital
| | - Manjushree Guatam
- MANJUSHREE GUATAM MD, Medical Resident, Methodist Hospital, Philadelphia
| | - Joan K Schmutz
- JOAN K SCHMUTZ BSN, Clinical Coordinator, Temple University Hospital
| | - Kevin S Skole
- KEVIN S SKOLE MD, Gastroenterology Fellow, Temple University Hospital
| | - Rebecca M Thomas
- REBECCA M THOMAS MD, Professor of Medicine and Pathology, Temple University Hospital
| | - Martin Black
- MARTIN BLACK MD, Emeritus Professor of Medicine, Temple University Hospital
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