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Ramachandran R, Grantham T, Isaac-Coss G, Etienne D, Reddy M. Gastroduodenal Involvement in AL Amyloidosis: Case Report and Literature Review. J Investig Med High Impact Case Rep 2024; 12:23247096241237759. [PMID: 38462925 PMCID: PMC10929022 DOI: 10.1177/23247096241237759] [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: 06/29/2023] [Revised: 01/29/2024] [Accepted: 02/17/2024] [Indexed: 03/12/2024] Open
Abstract
Gastrointestinal amyloidosis is a rare condition commonly found in the setting of systemic AL amyloidosis. Amyloid can deposit throughout the gastrointestinal tract and the resulting symptoms vary depending on the site of deposition. Gastrointestinal (GI) manifestations can range from weight loss or abdominal pain, to more serious complications like gastrointestinal bleeding, malabsorption, dysmotility, and obstruction. This case describes a patient with known history of IgG lambda AL amyloidosis, presenting with epigastric pain and unintentional weight loss found to have gastroduodenal amyloidosis. The definitive diagnosis of GI amyloidosis requires endoscopic biopsy with Congo red staining and visualization under polarized light microscopy. There are currently no specific guidelines for the management of GI amyloidosis. Generally, the goal is to treat the underlying cause of the amyloidosis along with symptom management. Our patient is being treated with cyclophosphamide, bortezomib, and dexamethasone (CyBorD) and started on hemodialysis due to progression of renal disease.
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Grantham T, Ramachandran R, Parvataneni S, Budh D, Gollapalli S, Gaduputi V. Epidemiology of Gastric Cancer: Global Trends, Risk Factors and Premalignant Conditions. J Community Hosp Intern Med Perspect 2023; 13:100-106. [PMID: 38596548 PMCID: PMC11000854 DOI: 10.55729/2000-9666.1252] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 08/02/2023] [Accepted: 08/10/2023] [Indexed: 04/11/2024] Open
Abstract
This review article aims to provide a comprehensive overview of recent epidemiology, pathogenesis, risk factors, and premalignant conditions of gastric cancer. Worldwide, gastric cancer is one of the most common and most fatal cancers. The incidence and mortality remain high in regions such as East Asia and Eastern Europe. Although there is a lower incidence in the United States, it remains a deadly disease. Age, gender, and race are non-modifiable demographic risk factors for developing gastric cancer. There have been several dietary and lifestyle risk factors such as salt preserved foods, N-nitroso compounds containing foods, tobacco smoke, alcohol use, and obesity that have been shown to contribute to the development of gastric cancer. Infections have additionally been shown to have a clear role in the pathogenesis of gastric cancer as Helicobacter pylori eradication has shown a significant reduction in the incidence of gastric cancer as well as other pathogens such as Epstein-Barr virus. There are certain premalignant lesions that increase the risk of developing gastric cancer. These include atrophic gastritis, and intestinal metaplasia amongst others.
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Affiliation(s)
- Tyler Grantham
- Department of Internal Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305,
USA
| | | | - Swetha Parvataneni
- Department of Internal Medicine, Geisinger Lewistown Hospital, 400 Highland Ave, Lewistown, PA 17044,
USA
| | - Deepa Budh
- Department of Internal Medicine, St. Barnabas Hospital, 4422 3rd Avenue, Bronx, NY 10457,
USA
| | - Sindhu Gollapalli
- Department of Internal Medicine, St. Barnabas Hospital, 4422 3rd Avenue, Bronx, NY 10457,
USA
| | - Vinaya Gaduputi
- Department of Gastroenterology, Blanchard Valley Health System, 1900 S Main St, Findlay, OH 45840,
USA
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Grantham T, Khan S, Behgal J, Rizvi T, Glaser A. Recurrent acute-onset of chronic inflammatory demyelinating polyneuropathy after COVID-19 vaccination. IDCases 2023; 33:e01809. [PMID: 37273773 PMCID: PMC10236287 DOI: 10.1016/j.idcr.2023.e01809] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 06/06/2023] Open
Abstract
This is the case of 54-year-old male with a past medical history of Chronic Inflammatory Demyelinating Polyneuropathy (CIPD) who was found to have an acute exacerbation of CIPD shortly after receiving his 1st COVID 19 booster (3rd dose of vaccination series) and was successfully treated with intravenous immunoglobulin (IVIG) and then was found to have another acute exacerbation of CIDP 6 months later after receiving his 2nd COVID 19 booster (4th dose of vaccination series) that required intubation and long term tracheostomy. CIPD is an acquired immune-mediated polyneuropathy that mainly affects the peripheral nerve roots nerves. It typically presents with relapsing/remitting, or progressive symmetrical muscle weakness and sensory involvement and can cause decreased respiratory effort. COVID-19 is mainly a respiratory disease, but it has been associated with a wide variety of neurological conditions. Although there have been several findings of acute inflammatory demyelinating polyneuropathy in association with COVID-19, CIDP exacerbation as a result of COVID-19 has rarely been seen in the literature. Furthermore, CIDP exacerbation as a result of COVID-19 vaccination is even less frequently seen.
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Affiliation(s)
- Tyler Grantham
- Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY 10305, United States of America
| | - Shahkar Khan
- Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY 10305, United States of America
| | - Jai Behgal
- Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY 10305, United States of America
| | - Taqi Rizvi
- Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY 10305, United States of America
| | - Allison Glaser
- Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY 10305, United States of America
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Ramachandran R, Kumar V, Grantham T, Etienne D, Reddy M. Conservative Management of Duodenal Penetration by Inferior Vena Cava Filter: Case Report and Review. J Investig Med High Impact Case Rep 2023; 11:23247096231192815. [PMID: 37610107 PMCID: PMC10460035 DOI: 10.1177/23247096231192815] [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: 04/17/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 08/24/2023] Open
Abstract
Duodenal penetration is a late complication associated with the placement of inferior vena cava (IVC) filters. In this case report, we are presenting a case of asymptomatic duodenal penetration by IVC filter that was managed conservatively.
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Affiliation(s)
| | - Vikash Kumar
- Department of Internal Medicine, The Brooklyn Hospital Center, NY, USA
| | - Tyler Grantham
- Department of Internal Medicine, Staten Island University Hospital, NY, USA
| | - Denzil Etienne
- Department of Gastroenterology, The Brooklyn Hospital Center, NY, USA
| | - Madhavi Reddy
- Department of Gastroenterology, The Brooklyn Hospital Center, NY, USA
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Uhlenhopp DJ, Ramachandran R, Then E, Parvataneni S, Grantham T, Gaduputi V. COVID-19-Associated Ischemic Colitis: A Rare Manifestation of COVID-19 Infection-Case Report and Review. J Investig Med High Impact Case Rep 2022; 10:23247096211065625. [PMID: 35343847 PMCID: PMC8966066 DOI: 10.1177/23247096211065625] [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] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Following the first report of COVID-19 infection in December 2019 as a respiratory illness, it has proven to be a multisystem disease. There are few reported cases of ischemic colitis with COVID-19 infection in the medical literature to date and we have limited understanding of its pathophysiology. We report 2 cases of ischemic colitis as the only manifestation of COVID-19. In addition, we review the current limited literature regarding COVID-19-associated ischemic colitis.
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Affiliation(s)
| | | | - Eric Then
- The Brooklyn Hospital Center, NY, USA
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Then EO, Grantham T, Deda X, Ramachandran R, Gaduputi V. Metastatic Gastric Cancer to the Colon. World J Oncol 2021; 12:127-131. [PMID: 34349858 PMCID: PMC8297054 DOI: 10.14740/wjon1375] [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] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 04/29/2021] [Indexed: 12/09/2022] Open
Abstract
Gastric cancer is one of the most common and deadly cancers worldwide, especially amongst older males. Current data suggest gastric cancer is the fifth most common neoplasm and the third most deadly cancer, with an estimated 783,000 deaths in 2018. Risk factors associated with the development of gastric cancer include obesity, gastroesophageal reflux disease, Helicobacter pylori infection, and low socioeconomic status. Diagnosis of gastric cancer can be accomplished by endoscopy, which allows the clinician to obtain a biopsy specimen. Endoscopic ultrasound is also an important modality that is helpful in assessing tumor invasion. The most common sites of metastatic gastric cancer in descending order are the liver, peritoneum, lung and bone. Rarely will gastric cancer metastasize to the colon. Here we present a rare case of colonic metastasis of a primary gastric adenocarcinoma.
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Affiliation(s)
- Eric Omar Then
- Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, NY, USA.,Division of Gastroenterology and Hepatology, SBH Health System, Bronx, NY, USA
| | - Tyler Grantham
- Department of Internal Medicine, St. George's University School of Medicine, Grenada, West Indies
| | - Xheni Deda
- Division of Gastroenterology and Hepatology, SBH Health System, Bronx, NY, USA
| | - Rajarajeshwari Ramachandran
- Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, NY, USA
| | - Vinaya Gaduputi
- Division of Gastroenterology and Hepatology, SBH Health System, Bronx, NY, USA
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Then EO, Grantham T, Lopez M, Reddy M, Gaduputi V. Esophagitis Dissecans Superficialis (EDS) Secondary to Hair Dye Ingestion: Case Report and Literature Review. Clin Pract 2021; 11:185-189. [PMID: 33805260 PMCID: PMC8103253 DOI: 10.3390/clinpract11020026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/24/2021] [Accepted: 03/22/2021] [Indexed: 11/21/2022] Open
Abstract
Esophagitis dissecans superficialis (EDS) is a rare and underdiagnosed esophageal lesion characterized by sloughing of the esophageal mucosa that has been associated with medications, various autoimmune disorders, and exposure to some chemical irritants. Anatomically, EDS is most commonly seen in the middle and distal thirds of the esophagus. When present, EDS is best treated by discontinuing the offending agent and initiating pharmacologic therapy with proton pump inhibitors. Steroids may also be effective if the etiology is autoimmune in nature. Our case highlights a 65-year-old female diagnosed with EDS after incidental ingestion of hair dye containing resorcinol and para-phenylenediamine (PPD).
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Affiliation(s)
- Eric Omar Then
- Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, NY 11201, USA;
- Division of Gastroenterology and Hepatology, SBH Health System, Bronx, NY 10457, USA; (M.L.); (V.G.)
- Correspondence: ; Tel.: +1-(917)-544-9015
| | - Tyler Grantham
- Department of Internal Medicine, St. George’s University School of Medicine, West Indies, Grenada;
| | - Michell Lopez
- Division of Gastroenterology and Hepatology, SBH Health System, Bronx, NY 10457, USA; (M.L.); (V.G.)
| | - Madhavi Reddy
- Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, Brooklyn, NY 11201, USA;
| | - Vinaya Gaduputi
- Division of Gastroenterology and Hepatology, SBH Health System, Bronx, NY 10457, USA; (M.L.); (V.G.)
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Dalal RC, Eberhard R, Grantham T, Mayer DG. Application of sustainability indicators, soil organic matter and electrical conductivity, to resource management in the northern grains region. ACTA ACUST UNITED AC 2003. [DOI: 10.1071/ea00186] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Sustainability is a multifaceted concept. It is expressed here as 'to ensure that the past and current management and use of natural resources does not diminish their capacity to meet economic, environmental, social and aesthetic needs and opportunities of the present and future generations'. Sustainability indicators can be used to monitor responses in condition and trend as a result of natural resource management. We report here 2 case studies that demonstrate the significance of sustainability indicators in discerning trends in land and water resources in the southern Brigalow (Acacia harpophylla) Belt, a major region of the Queensland Murray–Darling Basin. First, soil organic matter was used as a sustainability indicator of soil productivity, soil aggregation, and its association with soil sodicity since these soil attributes affect infiltration rates, runoff and drainage. The second study involved comparing the trends in stream salinity (electrical conductivity) over 35 years and sustainability indicators for a dominant Vertosol in a region used for cereal cropping. Groundwater level and electrical conductivity of a long-term monitoring bore in the Dalby–Chinchilla region, were also analysed to discern trends in salinity and association of the groundwater with soil and stream salinity. Soil organic matter declined exponentially as the cultivation period for cereal cropping increased. This resulted in a reduction in soil nitrogen supply, and lower grain protein and cereal grain yields. The associated effects were reduced soil aggregation and increased soil sodicity. Electrical conductivity of the soil as well as stream water showed weak but declining trends with time. Groundwater level from the long-term monitoring bore near the stream and groundwater salinity showed significantly declining trends over the 35 years sampling period. Groundwater salinity was similar to the Vertosol electrical conductivity at 240–300 cm depths, suggesting groundwater connectivity to the overlaying soil. Thus, use of sustainability indicators provided a strong association among the various attributes of the landscape. However, it is still a challenge to integrate the various sustainability indicators in a landscape context, integrated over space (spatial and geographical distribution), attributes (quality characteristics) and time (trend).
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