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| 1 | Duodenal variceal bleeding with large spontaneous portosystemic shunt treated with transjugular intrahepatic portosystemic shunt and embolization: A case report显示文摘BACKGROUND Duodenal variceal bleeding is a rare cause of gastrointestinal bleeding. The most common site is the duodenal bulb. It is usually detected endoscopically but it can be very challenging to diagnose if it is located distal to the second part od duodenum. The pre- transjugular intrahepatic portosystemic shunt (TIPS) presence of spontaneous portosystemic shunt (SPSS) was found to be associated with an increased risk of early morbidity and mortality after TIPS placement. CASE SUMMARY A 43-year-old cirrhotic male presented with melena for three days. Upper endoscopy was performed and showed active blood oozing from the distal duodenum concerning for ectopic duodenal varix. A computed tomography (CT) angiogram was performed and showed an enlarged cluster of venous collaterals around the distal duodenum. He underwent TIPS placement. He had another episode of melena three days later. Push enteroscopy with injection sclerotherapy into the duodenal varices was performed with no success. A repeat CT angiogram showed occluded TIPS shunt. Therefore, a TIPS revision was performed and there was an extensive portal venous thrombosis with a large shunt between the inferior mesenteric vein and left renal vein via the left gonadal vein. Thrombectomy and TIPS shunt balloon angioplasty was performed, followed by embolization of the portosystemic. The melena was resolved, and patient was discharged with arranged hepatology follow up. CONCLUSION It importance to look and embolize the SPSS shunts in patients with early TIPS dysfunction and recurrent duodenal variceal bleeding. | Rohit Anand Saad Emhmed Ali Driss Raissi Wesam M Frandah | 2019 | World Journal of Radiology2019，11，8： | 7 |
| 2 | Left Ventricular Assist Devices and Gastrointestinal Bleeding: A Narrative Review of Case Reports and Case Series显示文摘 | Sameer Islam Cihan Cevik Rosalinda Madonna Wesam Frandah Ebtesam Islam Sherazad Islam Kenneth Nugent | 2013 | Clin Cardiol2013，，： | 2 |
| 3 | Should a fully covered self-expandable biliary metal stent be anchored with a double-pigtail plastic stent? A retrospective study显示文摘BACKGROUND The migration rate of fully covered self-expandable metal stents(FCSEMSs) has been reported to be between 14% to 37%. Anchoring of FCSEMSs using a doublepigtail plastic stent(DPS) may decrease migration.AIM To compare stent migration rates between patients who received FCSEMS alone and those who received both an FCSEMS and anchoring DPS.METHODS We conducted a retrospective analysis of endoscopy reporting system and medical records of 1366 patients who underwent endoscopic retrograde cholangiopancreatography(ERCP) with FCSEMS placement at the University of Kentucky health care. Between July 2015 and April 2017,203 patients with FCSEMS insertion for the treatment of malignant biliary stricture,benign biliary stricture,post-sphincterotomy bleeding,bile leak,and cholangitis drainage were identified. The review and analysis were conducted through our endoscopy reporting system(ProVation~? MD) and medical records. Categorical data were analyzed using Chi-Square and Fischer exact test and continuous data using nonparametric tests. A regression analysis was performed to identify factors independently associated with increased risk of stent migration. We determinedan FCSEMS migration endoscopically if the stent was no longer visible in the major papilla.RESULTS1366 patients had undergone ERCP by three advanced endoscopists over 21-mo period; among these,203 patients had FCSEMSs placed. 65 patients had FCSEMSs with DPS,and 138 had FCSEMSs alone. 65 patients had FCSEMSs with DPS,and 138 had FCSEMSs alone. 95 patients had a malignant stricture,82 patients had a benign stricture,12 patients had bile leak,12 patients had cholangitis,and nine patients had post-sphincterotomy bleeding. The migration rate in patients with anchored FCSEMSs with DPS was 6%,and those without anchoring DPS was 10%(P = 0.35). Overall,migration was reported in 18 patients with FCSEMSs placement out of 203 patients with an overall migration rate of 9.7%. There was no significant association between anchoring the FCSEMSs with DPS and the risk of stent migration. Only patients with the previous sphincterotomy and begin biliary stricture were found to have a statistically significant difference in the migration rate between patients who had FCSEMS with DPS and FCSEMS alone(P = 0.01).CONCLUSION The risk of migration of biliary FCSEMS was 9.7 %. Anchoring an FCSEMS with DPS does not decrease the risk of stent migration. | Saad Emhmed Ali Wesam M Frandah Leon Su Cory Fielding Houssam Mardini | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，5： | 1 |
| 4 | Left Ventricular Assist Devices and Gastrointestinal Bleeding: A Narrative Review of Case Reports and Case Series显示文摘 | Sameer Islam Cihan Cevik Rosalinda Madonna Wesam Frandah Ebtesam Islam Sherazad Islam Kenneth Nugent | 2013 | Clin Cardiol2013，，4： | 1 |
| 5 | Physician-scientists or celebrities?Kardashian-index of gastroenterologists显示文摘BACKGROUND The coronavirus disease 2019 pandemic unleashed a flood of untrustworthy information on social media platforms,resulting in the unfortunate consequence of expert scientists'opinions getting lost amidst the chaotic sea of misinformation.The question of how much influence these esteemed scientists hold on social media platforms remains elusive.To address this scientific quandary,we sought to explore the concept of the Kardashian index(K-index),a term introduced by Hall in 2014.This metric provides a rudimentary means of evaluating whether a physician scientist's popularity on social media aligns with their significant scientific contributions.AIM To evaluate if a Gastroenterologist physician's popularity on social media is at par with their scientific contributions(research articles and publications).METHODS We conducted an extensive search to identify all gastroenterologists actively practicing and associated with the top 100 hospitals as reported by the United States News.We collected specific data on a sub-group including their names,affiliations,degrees,and sub-specializations.To gauge their social media popularity,we utilized the K-index calculation which is determined by dividing the actual number of Twitter followers by the number of researcher’s citations.The expected number of followers(F)is calculated using the formula F=43.3 C^0.32,where C represents the number of citations.RESULTS Physicians affiliated with the Mayo Clinic emerged as the most prominent presence on Twitter,constituting 16%of the total.They were followed closely by physicians from Mount Sinai Hospital(9%)and the University of Michigan Hospital(9%).Surprisingly,76%of the physicians evaluated exhibited a low K-index,falling within the range of 0 to less than 2.This suggests that a significant number of highly influential physician-scientists are not receiving due recognition,as indicated by their relatively low number of followers.On the other hand,24%of the physicians had an inflated K-index,exceeding 5,which positioned them as the'Kardashians'.These individuals enjoyed greater social media popularity than their actual scientific contributions.Interestingly,our analysis revealed no discernible association between sex and K-index(P value of 0.92).CONCLUSION In the gastroenterology field,our study estimated that a majority(76%)of highly researched physicians are undervalued despite their significant scientific contributions. | Onyinye Ugonabo Saad Ullah Malik Usman Ali Akbar Zarlakhta Zamani Wesam Frandah | 2023 | World Journal of Methodology2023，13，4： | 0 |
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