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Desai M, Rex DK, Bohm ME, Davitkov P, DeWitt JM, Fischer M, Faulx G, Heath R, Imler TD, James-Stevenson TN, Kahi CJ, Kessler WR, Kohli DR, McHenry L, Rai T, Rogers NA, Sagi SV, Sathyamurthy A, Vennalaganti P, Sundaram S, Patel H, Higbee A, Kennedy K, Lahr R, Stojadinovikj G, Campbell C, Dasari C, Parasa S, Faulx A, Sharma P. Impact of withdrawal time on adenoma detection rate: results from a prospective multicenter trial. Gastrointest Endosc 2023; 97:537-543.e2. [PMID: 36228700 DOI: 10.1016/j.gie.2022.09.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 08/09/2022] [Revised: 09/07/2022] [Accepted: 09/23/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Performing a high-quality colonoscopy is critical for optimizing the adenoma detection rate (ADR). Colonoscopy withdrawal time (a surrogate measure) of ≥6 minutes is recommended; however, a threshold of a high-quality withdrawal and its impact on ADR are not known. METHODS We examined withdrawal time (excluding polyp resection and bowel cleaning time) of subjects undergoing screening and/or surveillance colonoscopy in a prospective, multicenter, randomized controlled trial. We examined the relationship of withdrawal time in 1-minute increments on ADR and reported odds ratio (OR) with 95% confidence intervals. Linear regression analysis was performed to assess the maximal inspection time threshold that impacts the ADR. RESULTS A total of 1142 subjects (age, 62.3 ± 8.9 years; 80.5% men) underwent screening (45.9%) or surveillance (53.6%) colonoscopy. The screening group had a median withdrawal time of 9.0 minutes (interquartile range [IQR], 3.3) with an ADR of 49.6%, whereas the surveillance group had a median withdrawal time of 9.3 minutes (IQR, 4.3) with an ADR of 63.9%. ADR correspondingly increased for a withdrawal time of 6 minutes to 13 minutes, beyond which ADR did not increase (50.4% vs 76.6%, P < .01). For every 1-minute increase in withdrawal time, there was 6% higher odds of detecting an additional subject with an adenoma (OR, 1.06; 95% confidence interval, 1.02-1.10; P = .004). CONCLUSIONS Results from this multicenter, randomized controlled trial underscore the importance of a high-quality examination and efforts required to achieve this with an incremental yield in ADR based on withdrawal time. (Clinical trial registration number: NCT03952611.).
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Affiliation(s)
- Madhav Desai
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA; Division of Gastroenterology, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Douglas K Rex
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Matthew E Bohm
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Perica Davitkov
- Department of Gastroenterology and Hepatology, Louis Stokes VA Medical Center, Cleveland, Ohio, USA
| | - John M DeWitt
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Monika Fischer
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Ryan Heath
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Timothy D Imler
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Toyia N James-Stevenson
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Charles J Kahi
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - William R Kessler
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Divyanshoo R Kohli
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Lee McHenry
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Tarun Rai
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Nicholas A Rogers
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sashidhar V Sagi
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Anjana Sathyamurthy
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Prashanth Vennalaganti
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Suneha Sundaram
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Harsh Patel
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - April Higbee
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Kevin Kennedy
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Rachel Lahr
- Department of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Gjorgie Stojadinovikj
- Department of Gastroenterology and Hepatology, Louis Stokes VA Medical Center, Cleveland, Ohio, USA
| | - Carlissa Campbell
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Chandra Dasari
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Sravanthi Parasa
- Department of Gastroenterology, Swedish Medical Center, Seattle, Washington, USA
| | - Ashley Faulx
- Department of Gastroenterology and Hepatology, Louis Stokes VA Medical Center, Cleveland, Ohio, USA
| | - Prateek Sharma
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA; Division of Gastroenterology, University of Kansas School of Medicine, Kansas City, Kansas, USA
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Duvvuri A, Bandla H, Thoguluva VC, Dasari C, Desai M, Nutalapati V, Moole V, Anvesh N, Harsh P, Gress F, Sharma P, Kohli DR. Comparing accuracy of high-risk features for detecting advanced neoplasia in pancreatic cystic lesions: a systematic review and meta-analysis. Ann Gastroenterol 2021; 34:743-750. [PMID: 34475747 PMCID: PMC8375658 DOI: 10.20524/aog.2021.0630] [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: 08/30/2020] [Accepted: 02/24/2021] [Indexed: 11/11/2022] Open
Abstract
Background The American Gastroenterological Association recommends endoscopic ultrasound (EUS) for evaluating pancreatic cystic lesions (PCL) with ≥2 high-risk features (HRF), whereas the American College of Gastroenterology recommends EUS for ≥1 HRF. This systematic review and meta-analysis compared the diagnostic accuracy of using ≥1 vs. ≥2 HRF for assessing the risk of advanced neoplasia (AN) and performing EUS in PCL. Methods An electronic database search was performed for eligible studies. AN was defined as pancreatic adenocarcinoma, intraductal papillary mucinous neoplasm or mucinous cystadenoma with high-grade dysplasia, pancreatic intraepithelial neoplasia and pancreatic neuroendocrine tumors. HRF included cyst size ≥3 cm, solid component, and dilated pancreatic duct ≥5 mm. The primary outcome was the sensitivity and specificity of using ≥1 vs. ≥2 HRF as an indication for EUS to detect AN in PCL. Results Of 38 studies initially screened, 8 were included in the final analysis. Seven studies assessed the accuracy of ≥2 HRF and 4 studies assessed ≥1 HRF. The pooled sensitivity, specificity, positive and negative predictive values of EUS for detecting AN were 41.7% (95% confidence interval 19.5-67.8%), 90.8% (81.9-95.5%), 30.4% (19.4-44.2%) and 94.3% (89.6-97.0%) with ≥2HRFs, and 77.1% (66.1-85.3%), 72.7% (50.4-87.5%), 17.95% (10.3-29.4%), 98.1% (90.8-99.6%), respectively, with ≥1 HRF. Conclusion Performing EUS for PCL with ≥1 HRF could offer greater sensitivity in detecting AN compared to ≥2 HRF, with a similar negative predictive value.
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Affiliation(s)
- Abhiram Duvvuri
- Gastroenterology and Hepatology, Kansas City VA Medical Center, Kansas City, MO (Abhiram Duvvuri, Vivek Chandrasekar Thoguluva, Chandra Dasari, Madhav Desai, Venkat Nutalapati, Prateek Sharma, Divyanshoo Rai Kohli).,Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, KS (Abhiram Duvvuri, Vivek Chandrasekar Thoguluva, Madhav Desai, Venkat Nutalapati, Patel Harsh)
| | - Harikrishna Bandla
- Saint Peter's University Hospitals, New Brunswick, NJ (Harikrishna Bandla)
| | - Vivek Chandrasekar Thoguluva
- Gastroenterology and Hepatology, Kansas City VA Medical Center, Kansas City, MO (Abhiram Duvvuri, Vivek Chandrasekar Thoguluva, Chandra Dasari, Madhav Desai, Venkat Nutalapati, Prateek Sharma, Divyanshoo Rai Kohli).,Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, KS (Abhiram Duvvuri, Vivek Chandrasekar Thoguluva, Madhav Desai, Venkat Nutalapati, Patel Harsh)
| | - Chandra Dasari
- Gastroenterology and Hepatology, Kansas City VA Medical Center, Kansas City, MO (Abhiram Duvvuri, Vivek Chandrasekar Thoguluva, Chandra Dasari, Madhav Desai, Venkat Nutalapati, Prateek Sharma, Divyanshoo Rai Kohli)
| | - Madhav Desai
- Gastroenterology and Hepatology, Kansas City VA Medical Center, Kansas City, MO (Abhiram Duvvuri, Vivek Chandrasekar Thoguluva, Chandra Dasari, Madhav Desai, Venkat Nutalapati, Prateek Sharma, Divyanshoo Rai Kohli).,Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, KS (Abhiram Duvvuri, Vivek Chandrasekar Thoguluva, Madhav Desai, Venkat Nutalapati, Patel Harsh)
| | - Venkat Nutalapati
- Gastroenterology and Hepatology, Kansas City VA Medical Center, Kansas City, MO (Abhiram Duvvuri, Vivek Chandrasekar Thoguluva, Chandra Dasari, Madhav Desai, Venkat Nutalapati, Prateek Sharma, Divyanshoo Rai Kohli).,Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, KS (Abhiram Duvvuri, Vivek Chandrasekar Thoguluva, Madhav Desai, Venkat Nutalapati, Patel Harsh)
| | - Vishnu Moole
- University of Illinois College of Medicine, Peoria, IL (Vishnu Moole)
| | - Narimiti Anvesh
- Saint Vincent Hospital, Worcester, MA (Narimiti Anvesh), USA
| | - Patel Harsh
- Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, KS (Abhiram Duvvuri, Vivek Chandrasekar Thoguluva, Madhav Desai, Venkat Nutalapati, Patel Harsh)
| | - Frank Gress
- Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY (Frank Gress)
| | - Prateek Sharma
- Gastroenterology and Hepatology, Kansas City VA Medical Center, Kansas City, MO (Abhiram Duvvuri, Vivek Chandrasekar Thoguluva, Chandra Dasari, Madhav Desai, Venkat Nutalapati, Prateek Sharma, Divyanshoo Rai Kohli)
| | - Divyanshoo Rai Kohli
- Gastroenterology and Hepatology, Kansas City VA Medical Center, Kansas City, MO (Abhiram Duvvuri, Vivek Chandrasekar Thoguluva, Chandra Dasari, Madhav Desai, Venkat Nutalapati, Prateek Sharma, Divyanshoo Rai Kohli)
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Duvvuri A, Desai M, Vennelaganti S, Higbee A, Gorrepati VS, Dasari C, Chandrasekar VT, Vennalaganti P, Kohli D, Sathyamurthy A, Rai T, Sharma P. Diagnostic accuracy of a novel third generation esophageal capsule as a non-invasive detection method for Barrett's esophagus: A pilot study. J Gastroenterol Hepatol 2021; 36:1222-1225. [PMID: 32996655 DOI: 10.1111/jgh.15283] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 05/24/2020] [Revised: 08/20/2020] [Accepted: 09/25/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIM Previous two generations of esophageal capsule did not show adequate detection rates for Barrett's esophagus (BE). We assessed the diagnostic accuracy of a novel third generation capsule with an improved frame rate of 35 frames per second for the detection of BE in a pilot study. METHODS This was a blinded prospective pilot study conducted at a tertiary medical center. Patients with known BE (at least C0M > 1) who presented for endoscopic surveillance (May to October 2017) were included. All patients underwent novel esophageal capsule (PillCam™ UGI; Medtronic) ingestion using the simplified ingestion protocol followed by standard high-definition upper endoscopy (esophagogastroduodenoscopy [EGD]). Capsule endoscopy findings were interpreted by examiners blinded to endoscopy results and compared with endoscopic findings (gold standard). Following completion of both tests, a subjective questionnaire was provided to all patients regarding their experience. RESULTS Twenty patients (95%males, mean age 66.3 [±7.9] years) with BE undergoing surveillance EGD were eligible. The mean BE length was 3.5 (±2.7) cm. Novel esophageal capsule detected BE in 75% patients when images were compared with endoscopy. Novel capsule detected BE in 82% patients when the BE length was ≥2 cm. The mean esophageal transit time was 0.59 s. On a subjective questionnaire, all 20 patients reported novel capsule as being more convenient compared with EGD. CONCLUSIONS In this pilot, single-center study, novel esophageal capsule was shown to be not ready for population screening of BE. Studies integrating artificial intelligence into improved quality novel esophageal capsule should be performed for BE screening.
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Affiliation(s)
- Abhiram Duvvuri
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Madhav Desai
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Sreekar Vennelaganti
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - April Higbee
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | | | - Chandra Dasari
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | | | - Prashanth Vennalaganti
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Divyanshoo Kohli
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Anjana Sathyamurthy
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Tarun Rai
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Prateek Sharma
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
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Desai M, Nutalapati V, Srinivasan S, Fathallah J, Dasari C, Chandrasekhar VT, Mohammad B, Kohli D, Vaezi M, Katz PO, Sharma P. Proton pump inhibitors do not increase the risk of dementia: a systematic review and meta-analysis of prospective studies. Dis Esophagus 2020; 33:5848915. [PMID: 32476013 DOI: 10.1093/dote/doaa041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 02/02/2020] [Revised: 04/18/2020] [Accepted: 04/26/2020] [Indexed: 12/11/2022]
Abstract
Published studies have reported variable results on the association between duration of proton pump inhibitor (PPI) use and the risk of dementia. An extensive literature search was performed in PubMed, Embase, Google Scholar, and Cochrane for studies examining the risk of cognitive decline and dementia among PPI users versus non-PPI users in prospective studies. Retrospective database linkage studies, case reports, case series, editorials, uncontrolled cohort studies, cross-sectional studies, and review articles were excluded. Primary outcome was pooled hazard rate (HR) of any dementia among PPI users compared with non-PPI users. Secondary outcomes were pooled HR of Alzheimer's dementia (AD) and risk with long-term PPI follow-up (more than 5 years) studies. Meta-analysis outcomes, heterogeneity (I2), and meta-regression (for the effect of covariates) were derived by statistical software R and Open meta-analyst. A total of six studies (one RCT and five prospective) with 308249 subjects, average age of 75.8 ± 5.2 years, and follow-up of 5 (range 1.5-11) years were included in the analysis. Pooled HR of any dementia was 1.16 (n = 6, 95% confidence interval (CI) = 0.86-1.47). Results remained unchanged when only studies with long-term PPI use (more than 5 years) were analyzed (n = 4, pooled HR 1.10, 95% CI 0.66-1.53). Finally, the pooled HR for AD was 1.06 (n = 3, 95% CI 0.70-1.41). There was substantial heterogeneity among inclusion studies (I2 = 93%). Meta-regression did not demonstrate a significant role of age at study start (P = 0.1) or duration of PPI use (P = 0.62) to incident dementia. The results of this systematic review and meta-analysis do not show a significant relationship between PPI use and dementia in prospective studies with at least a 5-year follow-up.
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Affiliation(s)
- Madhav Desai
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.,Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.,Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Gastroenterology, Weill Cornell Medical College, New York, New York, USA
| | - Venkat Nutalapati
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.,Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.,Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Gastroenterology, Weill Cornell Medical College, New York, New York, USA
| | - Sachin Srinivasan
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.,Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.,Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Gastroenterology, Weill Cornell Medical College, New York, New York, USA
| | - Jihan Fathallah
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.,Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.,Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Gastroenterology, Weill Cornell Medical College, New York, New York, USA
| | - Chandra Dasari
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.,Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.,Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Gastroenterology, Weill Cornell Medical College, New York, New York, USA
| | - Viveksandeep Thoguluva Chandrasekhar
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.,Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.,Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Gastroenterology, Weill Cornell Medical College, New York, New York, USA
| | - Bilal Mohammad
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.,Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.,Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Gastroenterology, Weill Cornell Medical College, New York, New York, USA
| | - Divyanshoo Kohli
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.,Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.,Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Gastroenterology, Weill Cornell Medical College, New York, New York, USA
| | - Michael Vaezi
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.,Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.,Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Gastroenterology, Weill Cornell Medical College, New York, New York, USA
| | - Philip O Katz
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.,Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.,Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Gastroenterology, Weill Cornell Medical College, New York, New York, USA
| | - Prateek Sharma
- Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.,Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.,Department of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Department of Gastroenterology, Weill Cornell Medical College, New York, New York, USA
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Dasari C, Podugu A, jihad D, alasady J, Nemer O, Bolyard J, Boutros N. 734. Crit Care Med 2014. [DOI: 10.1097/01.ccm.0000458231.84603.2c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Podugu A, Rizvi K, Dasari C, Chakka A, Boutros N. A Rare Case of Fatal Thyroid Storm (TS) Resulting in DIC and Multiorgan Failure. Chest 2014. [DOI: 10.1378/chest.1992592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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