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The Socioeconomic Impact on Presentation and Clinical Course of Celiac Disease
Christopher Cao, MD; Peter Block, MD; Madeline Russell, MD; Justin Robbins, MD; Anthony J. DiMarino, MD; and Stephanie Moleski
Introduction
- Celiac Disease (CD) is a chronic autoimmune condition primarily affecting the small intestine.
- CD is triggered by ingestion of gluten and the only effective treatment for CD involves strict and lifelong elimination of dietary gluten.
- Compliance with the gluten free diet (GFD) relies on purchasing gluten-free foods. Studies have shown the cost of a GFD to be from 76% to 518% more expensive than gluten containing counterparts. Because of this, the economic burden that CD patients face may be substantial, placing these patients at high risk for dietary neglect.
- Financial limitation aside, GFD availability also varies by differing neighborhoods, resulting in economic food deserts across the country.
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Effect of Nutritional Intervention on Patients with Gastroparesis
Emily Rubin, RD; Melissa Viscuso, RD; Kamal Amer, MD; Joseph Yoo, MD; Anthony DiMarino, MD; and Stephanie Moleski, MD
Study Aims
- Utilize the PAGI-SYM survey as an assessment tool in following clinical symptoms of patients with GP.
- Determine if a formal consultation with a Registered Dietitian (RD) provided benefit to patients documented gastroparesis.
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The Sensitivity of Cross-Sectional Imaging for Identifying Periampullary Diverticula
Austin Chiang, MD, MPH; Jetmir Vojnika, MD; Alexander Schlachterman, MD; David E. Loren, MD; and Thomas E. Kowalski
Our aim was to determine the sensitivity of imaging in identifying duodenal diverticula as seen during ERCP.
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Intrahepatic Cholangiocarcinoma Presenting as LI-RADS 5 "HCC"
Raja K. Dhanekula, MD; Donald Mitchell, MD; John Farber, MD; Ashwin R. Sama, MD; and Jesse M. Civan, MD
Background
• Hepatocellular Carcinoma (HCC), if within Milan Criteria, is an indication for liver transplantation.
• In contrast, intrahepatic cholangiocarcinoma (IHCC) is a contra-indication to liver transplantation due to high rates of recurrence.
• LI-RADS 5 classification (synonymous with OPTN-5) carries a near 100% positive predictive value for HCC, allowing prioritization of patients for liver transplantation without histological confirmation.
• The “LI-RADS M” classification indicates the presence of malignancy not meeting diagnostic criteria for HCC. In theory, IHCC lesions should be identified as LI-RADS M and not LI-RADS 5.
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A Case of Arterioportal Fistula Leading to Non-cirrhotic Portal Hypertension
Sheela S. Reddy; Raja K. Dhanekula, MD; Warren R. Maley, MD; Colette Shaw, MD; Jesse M. Civan, MD; David A. Sass, MD; Jonathan M. Fenkel, MD; Susan Shamini Noori, MD; and Dina Halegoua-De Marzio, MD
Background
• Arterioportal fistula (APF) is a rare cause of non-cirrhotic portal hypertension.
• This is a case of a hepatic artery-portal vein fistula presenting with recurrent variceal hemorrhage and ascites in a patient with no known liver disease.
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Detection of genetic and epigenetic DNA markers in urine for the early detection of primary and recurrent hepatocellular carcinoma
Hie-Won Hann, Surbhi Jain, Ting-Tsung Chang, Chi-Tan Hu, Selena Lin, Wei Song, and Ying-Hsiu Su
Poster presented at American Association of the Study of Liver Diseases (AASLD) meeting in San Francisco California.
Objective:
Develop a urine test using a panel of select genetic and epigenetic markers for the early detection of primary and recurrent HCC.
Introduction:
Hepatocellular carcinoma (HCC) or liver cancer is an aggressive disease and one of the fastest growing cancers by incidence in the United States. Early detection is the key for effective treatment of HCC as the 5-year survival rate is 26% in early stage HCC as compared to only 2% when found after spreading to distant organs. The current marker, alpha-feto protein (AFP) and its fucosylated glycoform, L3, are of limited value with only 40-60% sensitivity.
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