Notes

Circulating extracellular vesicles are a biomarker with regard to NAFLD solution as well as response to bariatric surgery.
During fasting, one-third of all MMC originated in the antrum. MEK inhibitor side effects Azithromycin-induced MMC occurred in 28% of subjects and two-thirds of these originated in the antrum with antral contractions of significantly higher frequency and amplitude compared to fasting. Octreotide significantly increased frequency, amplitude, and duration of MMC compared to fasting, with 76% originating in the antrum. Both azithromycin and octreotide induced more than one MMC in a third of subjects.

We describe the characteristics of antral and small intestinal motility during fasting and after provocative testing in children. These values will help standardize our interpretation of pediatric ADM studies.
We describe the characteristics of antral and small intestinal motility during fasting and after provocative testing in children. These values will help standardize our interpretation of pediatric ADM studies.
Cannabis Hyperemesis Syndrome (CHS) is characterized by recurrent episodes of intractable emesis associated with heavy use of cannabis. Recognition of CHS can be problematic due to the lack of specific biomarkers, which can point the clinician to the diagnosis. We present, retrospectively, a series of adolescent/young adult patients who presented to a pediatric gastroenterology (GI) service with acute on chronic nausea and vomiting, subsequently found to have CHS with associated elevated urinary cannabis metabolite concentrations.

We describe 15 patients referred to our pediatric GI division for intractable emesis with spot urinary cannabis metabolite carboxy-THC (THC-COOH) concentrations from January 1, 2018 through April 20, 2019. Urinary testing was performed using gas chromatography mass spectrometry (GC-MS) in a manner consistent with CLIA requirements at Mayo Clinic laboratory (Rochester, MN). The laboratory cutoffs were 3.0 ng/mL. Data was extracted via chart review and analyzed via online statistirinary THC-COOH level usually exceeding 100ng/mL, which is indicative of significant chronic cannabis exposure. In patients with a history consistent with CHS, urine THC-COOH testing may help guide the diagnostic evaluation of these patients and decrease the need for further workup.
Cannabis Hyperemesis Syndrome is associated with an elevated urinary THC-COOH level usually exceeding 100ng/mL, which is indicative of significant chronic cannabis exposure. In patients with a history consistent with CHS, urine THC-COOH testing may help guide the diagnostic evaluation of these patients and decrease the need for further workup.
We reviewed INSPPIRE (INternational Study Group of Pediatric Pancreatitis In Search for a CuRE) database for splanchnic venous thrombosis or arterial pseudoaneurysms to determine the incidence, risk factors and outcomes of peripancreatic vascular complications in children with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP). Of 410 children with diagnostic imaging studies, vascular complications were reported in 5 (1.2%); 2 had ARP, 3 CP. The vascular events were reported during moderately severe or severe acute pancreatitis (AP) in 4, mild AP in 1. Venous thrombosis occurred in 4, arterial pseudoaneurysm (left gastric artery) in 1. 2 patients with venous thrombosis were treated with anticoagulant, 1 achieved recanalization (splenic vein). In 2 patients who did not receive anticoagulants, 1 re-canalized. No adverse effects were observed with anticoagulants. The child with pseudoaneurysm underwent aneurysmal coiling. Anti-coagulants appear to be safe in children with acute pancreatitis, their be safe in children with acute pancreatitis, their long-term benefit needs to be further investigated.
Patients with chronic kidney disease are at increased risk for choroidal effusion development following glaucoma surgery.

Choroidal effusion is a postoperative complication of glaucoma surgery that results from a transudative fluid collection in the suprachoroidal space. Kidney disease alters bodily fluid dynamics through a variety of mechanisms. The relationship between chronic kidney disease and choroidal effusion following glaucoma surgery has not previously been studied. The purpose of this study was to determine the relationship between chronic kidney disease and choroidal effusion development after glaucoma surgery.

This retrospective cohort study consisted of 86 eyes from 86 patients who received glaucoma filtering surgery or transscleral cyclophotocoagulation within the study timeframe. Forty-three patients had chronic kidney disease and 43 patients did not have kidney disease. The main outcome of this study was the development of choroidal effusion measured by Pearson's chi-squared test and multivariate analyses using a binomial regression with a log link.

Ten patients (23.3%) in the chronic kidney disease group developed choroidal effusion while two patients (4.7%) in the no-kidney disease group developed choroidal effusion (relative risk, 5.0; 95% confidence interval 1.16 to 21.5; P=0.013). The association between chronic kidney disease and choroidal effusion showed mixed results in the multivariate analyses, with some analyses showing a significant association and others showing no significant association.

In both the univariate analysis and multivariate analysis, chronic kidney disease was found to be significantly associated with choroidal effusion after glaucoma surgery.
In both the univariate analysis and multivariate analysis, chronic kidney disease was found to be significantly associated with choroidal effusion after glaucoma surgery.
To evaluate the effectiveness of bacterial cellulose membrane (BCM) in preventing fibrosis in trabeculectomy and the biocompatibility of BCM with conjunctiva and sclera.

Twenty-one eyes of 21 adult rabbits underwent fornix-based trabeculectomy. Standard surgery was done to control group (CG, n=7). Mitomycin-C (0.3▒mg/mL, 3▒min) was applied to MMC group only (MMCG, n=7). BCM (~100▒µm thick,10×10▒mm,single layer) was covered on the sclerotomy area before conjunctiva was closed in BCM group (BCMG, n=7). Intraocular pressures (IOP) were measured before, and 7, 14, 28 and 45 days after surgery (IOP-POD7,POD14,POD28,POD45). The IOP decrease were expressed as DIOP%-POD7, DIOP%-POD14,DIOP%-POD28 and DIOP%-POD45. The rabbits were sacrificed on the 45th day. Conjunctival vessel (CV) number, degrees of fibrosis, total inflammation, foreign body reaction (FBR), inflammatory cell types (B-cells,T-cells,plasma cells, macrophages, bleb spaces and the expression of α-smooth muscle actin(α-SMA) were studied using histopathology and immunohistochemistry techniques.
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