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| 1 | Early precut sphincterotomy and the risk of endoscopic retrograde cholangiopancreatography related complications: An updated meta-analysis显示文摘AIM: To study the cannulation and complication rates of early pre-cut sphincterotomy vs persistent attempts at cannulation by standard approach.METHODS: Systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant studies published up to February 2013. The main outcome measurements were cannulation rates and postendoscopic retrograde cholangiopancreatography(ERCP) complications. A comprehensive systematic search of the Cochrane library, PubMed, Google scholar, Scopus, National Institutes of Health, meta-register of controlled trials and published proceedings from major Gastroenterology journals and meetings until February 2013 was conducted using keywords. All Prospective randomized controlled trials(RCT) studies whichmet our inclusion criteria were included in the analysis. Prospective non-randomized studies and retrospective studies were excluded from our meta-analysis. The main outcomes of interest were post-ERCP pancreatitis, overall complication rates including cholangitis, ERCPrelated bleeding, perforation and cannulation success rates. RESULTS: Seven RCTs with a total of 1039 patients were included in the meta-analysis based on selection criteria. The overall cannulation rate was 90% in the pre-cut sphincterotomy vs 86.3% in the persistent attempts group(OR = 1.98; 95%CI: 0.70-5.65). The risk of post-ERCP pancreatitis(PEP) was not different between the two groups(3.9% in the pre-cut sphincterotomy vs 6.1% in the persistent attempts group, OR = 0.58, 95%CI: 0.32-1.05). Similarly, there was no statistically significant difference between the groups for overall complication rate including PEP, cholangitis, bleeding, and perforation(6.2% vs 6.9%, OR = 0.85, 95%CI: 0.51-1.41). CONCLUSION: This meta-analysis suggests that precut sphincterotomy and persistent attempts at cannulation are comparable in terms of overall complication rates. Early pre-cut implementation does not increase PEP complications. | Udayakumar Navaneethan Rajesh Konjeti Preethi GK Venkatesh Madhusudhan R Sanaka Mansour A Parsi | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，5： | 12 |
| 2 | Clostridium difficile infection and inflammatory bowel disease:Understanding the evolving relationship显示文摘Clostridium difficile(C.difficile)infection(CDI)is the leading identifiable cause of antibiotic-associated diarrhea.While there is an alarming trend of increasing incidence and severity of CDI in the United States and Europe,superimposed CDI in patients with inflammatory bowel disease(IBD)has drawn considerable attention in the gastrointestinal community.The majority of IBD patients appear to contract CDI as outpatients.C.difficile affects disease course of IBD in several ways,including triggering disease flares,sustaining activity,and in some cases,acting as an'innocent'bystander.Despite its wide spectrum of presentations,CDI has been reported to be associated with a longer duration of hospitalization and a higher mortality in IBD patients.IBD patients with restorative proctocolectomy or with diverting ileostomy are not immune to CDI of the small bowel or ileal pouch.Whether immunomodulator or corticosteroid therapy for IBD should be continued in patients with superimposed CDI is controversial.It appears that more adverse outcomes was observed among patients treated by a combination of immunomodulators and antibiotics than those treated by antibiotics alone.The use of biologic agents does not appear to increase the risk of acquisition of CDI.For CDI in the setting of underlying IBD,vancomycin appears to be more efficacious than metronidazole.Randomized controlled trials are required to clearly define the appropriate management for CDI in patients with IBD. | Udayakumar Navaneethan Preethi GK Venkatesh Bo Shen | 2010 | World Journal of Gastroenterology2010，16，39： | 12 |
| 3 | Factors predicting adverse short-term outcomes in patients with acute cholangitis undergoing ERCP: A single center experience显示文摘AIM: To identify potential factors that can predict adverse short-term outcomes in patients with acute cholangitis undergoing endoscopic retrograde cholangiopancreatography(ERCP). METHODS: Retrospective analysis of consecutive patients admitted to our center for acute cholangitis and underwent ERCP from 2001 to 2012. Involvement of two or more organ systems was termed as organ failure(OF). Cardiovascular failure was defined based on a systolic blood pressure of < 90 mmHg despite fluid replacement and/or requiring vasopressor treatment; respiratory failure if the Pa02 /Fi02 ratio was < 300 mmHg and/or required mechanical ventilation; coagulopathy if the platelet count was < 80; and renal insufficiency if serum creatinine was > 1.9 mg/dL. Variables associated with short term adverse clinical outcomes defined as persistent OF and/or 30-d mortality was determined. RESULTS: A total of 172 patients(median age 62 years, 56.4% female) were included. The median door to ERCP time was 17 h. Bile duct stones were the most common etiology(n = 67, 39.2%). In multivariate analysis, factors that were independently associated with persistent OF and/or 30-d mortality included American Society of Anesthesiology(ASA) physical classification score > 3(OR = 7.70; 95%CI: 2.73-24.40), presence of systemic inflammatory response syndrome(OR = 3.67; 95%CI: 1.34-10.3) and door to ERCP time greater than 72 h(OR = 3.36; 95%CI: 1.12-10.20). Door to ERCP time greater than 72 h was also associated with 70% increase in the mean length of stay(P < 0.001). Every one point increase in the ASA physical classification and every 1 mg/dL increase in the preERCP bilirubin level was associated with a 34% and 2% increase in the mean length of hospital stay, respectively. Transfer status did not impact clinical outcomes. CONCLUSION: Higher ASA physical classification and delays in ERCP are associated with adverse clinical outcomes and prolonged length of hospital stay in patients with acute cholangitis undergoing ERCP. | Udayakumar Navaneethan Norma G Gutierrez Ramprasad Jegadeesan Preethi GK Venkatesh Madhusudhan R Sanaka John J Vargo Mansour A Parsi | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，3： | 7 |
| 4 | Progressive Primary Sclerosing Cholangitis Requiring Liver Transplantation Is Associated With Reduced Need for Colectomy in Patients With Ulcerative Colitis显示文摘 | Udayakumar Navaneethan Preethi G.K. Venkatesh Saurabh Mukewar Bret A. Lashner Feza H. Remzi Arthur J. McCullough Ravi P. Kiran Bo Shen John J. Fung | 2012 | Clinical Gastroenterology and Hepatology2012，，5： | 2 |
| 5 | Clostridium difficile infection is associated with worse long term outcome in patients with ulcerative colitis显示文摘 | Udayakumar Navaneethan Saurabh Mukewar Preethi GK Venkatesh Rocio Lopez Bo Shen | 2011 | Journal of Crohn’s and Colitis2011，，3： | 2 |
| 6 | Impact of Clostridium difficile infection in patients with ulcerative colitis显示文摘 | Revital Kariv Udayakumar Navaneethan Preethi G.K. Venkatesh Rocio Lopez Bo Shen | 2010 | Journal of Crohn’s and Colitis2010，，1： | 2 |
| 7 | Delay in performing ERCP and adverse events increase the 30-day readmission risk in patients with acute cholangitis显示文摘 | Udayakumar Navaneethan Norma G. Gutierrez Ramprasad Jegadeesan Preethi G.K. Venkatesh Mujtaba Butt Madhusudhan R. Sanaka John J. Vargo Mansour A. Parsi | 2013 | Gastrointestinal Endoscopy2013，，1： | 1 |
| 8 | Endoscopic ultrasound in the diagnosis of cholangiocarcinoma as the etiology of biliary strictures:a systematic review and meta-analysis显示文摘Background and aim:Extrahepatic cholangiocarcinoma(CCA)typically presents as biliary strictures.Endoscopic ultrasound(EUS)-fine needle aspiration(FNA)may contribute to the diagnosis of CCA as the etiology of extrahepatic biliary strictures.Our aim was to study the uselfulness of EUS-FNA in diagnosing CCA as the etiology of biliary strictures.Patients and methods:In this meta-analysis,PUBMED and EMBASE databases were examined to find studies published to April 2014 where diagnostic correlation of CCA was available.Studies reporting only‘‘positive for malignancy’’were included in our analysis.The main outcome measurements were sensitivity,specificity and likelihood ratio.Results:Six studies were included,covering 196 patients.The overall pooled sensitivity and negative likelihood ratio(LR-)of EUS-FNA for diagnosis of CCA were 66%[95%confidence interval(CI)57-74%]and 0.34(95%CI 0.26-0.43),respectively.In five studies(146 patients),where a mass lesion was detected during EUS,the pooled sensitivity and LR-of EUS-FNA for diagnosis of CCA were 80%[95%CI 72-87%]and 0.20(95%CI 0.13-0.28),respectively.In the 49 patients with a negative brush cytology,the pooled sensitivity and LR-of EUS-FNA for diagnosis of CCA were 59%[95%CI 44-73%]and 0.41(95%CI 0.27-0.56),respectively.Conclusions:Our study suggests that EUS-FNA is useful in the evaluation of CCA as the etiology of biliary strictures.EUS-FNA may improve the diagnosis of CCA in patients with negative cytology and no mass on cross-sectional imaging. | Udayakumar Navaneethan Basile Njei Preethi G.K Venkatesh Vennisvasanth Lourdusamy Madhusudhan R Sanaka | 2015 | Gastroenterology Report2015，3，3： | 1 |
| 9 | Progressive Primary Sclerosing Cholangitis Requiring Liver Transplantation Is Associated With Reduced Need for Colectomy in Patients With Ulcerative Colitis显示文摘 | Udayakumar Navaneethan Preethi G.K. Venkatesh Saurabh Mukewar Bret A. Lashner Feza H. Remzi Arthur J. McCullough Ravi P. Kiran Bo Shen John J. Fung | 2012 | Clinical Gastroenterology and Hepatology2012，，5： | 1 |
| 10 | Duration and severity of primary sclerosing cholangitis is not associated with risk of neoplastic changes in the colon in patients with ulcerative colitis显示文摘 | Udayakumar Navaneethan Gursimran Kochhar Preethi G.K. Venkatesh Brian Lewis Bret A. Lashner Feza H. Remzi Bo Shen Ravi P. Kiran | 2012 | Gastrointestinal Endoscopy2012，，5： | 1 |
| 11 | Clostridium difficile infection is associated with worse long term outcome in patients with ulcerative colitis显示文摘 | Udayakumar Navaneethan Saurabh Mukewar Preethi GK Venkatesh Rocio Lopez Bo Shen | 2011 | Journal of Crohn’s and Colitis2011，，3： | 1 |
| 12 | Diagnosis and Therapeutic Management of Extra-Intestinal Manifestations of Inflammatory Bowel Disease显示文摘 | Guru Trikudanathan Preethi G. K. Venkatesh Udayakumar Navaneethan | 2012 | Drugs2012，，18： | 1 |
| 13 | Prevalence and risk factors for colonic perforation during colonoscopy in hospitalized inflammatory bowel disease patients显示文摘 | Udayakumar Navaneethan Sravanthi Parasa Preethi G.K. Venkatesh Guru Trikudanathan Bo Shen | 2010 | Journal of Crohn’s and Colitis2010，，： | 1 |
| 14 | Impact of Clostridium difficile infection in patients with ulcerative colitis显示文摘 | Revital Kariv Udayakumar Navaneethan Preethi G.K. Venkatesh Rocio Lopez Bo Shen | 2010 | Journal of Crohn’s and Colitis2010，，1： | 1 |
| 15 | Natural history of low grade dysplasia in patients with primary sclerosing cholangitis and ulcerative colitis显示文摘 | Preethi G.K. Venkatesh Ramprasad Jegadeesan Norma G. Gutierrez Madhusudhan R. Sanaka Udayakumar Navaneethan | 2013 | Journal of Crohn’s and Colitis2013，，： | 1 |
| 16 | Progression of low-grade dysplasia to advanced neoplasia based on the location and morphology of dysplasia in ulcerative colitis patients with extensive colitis under colonoscopic surveillance显示文摘 | Udayakumar Navaneethan Ramprasad Jegadeesan Norma G. Gutierrez Preethi G.K. Venkatesh Jeffrey P. Hammel Bo Shen Ravi P. Kiran | 2013 | Journal of Crohn’s and Colitis2013，，： | 1 |
| 17 | Severe disease on endoscopy and steroid use increase the risk for bowel perforation during colonoscopy in inflammatory bowel disease patients显示文摘 | Udayakumar Navaneethan Gursimran Kochhar Hardeep Phull Preethi GK Venkatesh Feza H. Remzi Ravi P. Kiran Bo Shen | 2011 | Journal of Crohn’s and Colitis2011，，4： | 1 |
| 18 | Clostridium difficile infection is associated with worse long term outcome in patients with ulcerative colitis显示文摘 | Udayakumar Navaneethan Saurabh Mukewar Preethi GK Venkatesh Rocio Lopez Bo Shen | 2011 | Journal of Crohn’s and Colitis2011，，3： | 1 |
| 19 | An Unusual Case of BSND Gene–Related (Type IV) Bartter Syndrome Presenting as Antenatal Bartter Syndrome:A Case Report and Review of Literature显示文摘Bartter syndrome is a group of autosomal recessive renal tubular disorders;it has two types of presentation:antenatal and classic.The antenatal type presents as severe unexplained polyhydramnios in the second trimester.This is due to fetal urinary losses of sodium,chloride,and potassium,leading to fetal polyuria.The classic type presents in the late neonatal or infancy stage,with dehydration,dyselectrolytemia,failure to thrive,and nephrocalcinosis.Antenatal scans are normal in such cases.Type I and II Bartter syndrome presents in the antenatal period,whereas type IV has a classic presentation.We describe an unusual case of type IVa Bartter syndrome presenting in the antenatal period,with severe polyhydramnios.The initial diagnosis was made based on amniotic fluid chloride levels and later confirmed by performing a genetic test.Genetic testing is important for confirming diagnosis and prognostication regarding the condition. | Aleena M.Shajan Manish Kumar Preethi Navaneethan Sumita Danda Manisha M.Beck | 2023 | Maternal-Fetal Medicine2023，5，2： | 0 |
| 20 | Bile proteomics for differentiation of malignant from benign biliary strictures:a pilot study显示文摘Background:Determining the etiology of biliary strictures is challenging,and the sensitivities of the current tests to diagnose them are low.Protein biomarkers in bile,in combination with other tests,may improve sensitivity in diagnosing biliary strictures.Objective:To analyse the differential abundance of proteins in benign and malignant biliary strictures through proteomic analysis of bile.Methods:In this prospective,cross-sectional study,bile was aspirated in 24 patients undergoing endoscopic retrograde cholangiopancreatography(ERCP)including six patients with primary sclerosing cholangitis(PSC),three with cholangiocarcinoma(CCA),ten with pancreatic cancer,and five with benign biliary conditions.Liquid chromatography/mass spectrometry was used to examine the bile for differential abundance of protein biomarkers.The relative abundance of various proteins was compared in the malignant vs.benign groups and in CCA vs.PSC.Results:The majority of the proteins identified in bile were similar to those of the plasma(plasma proteins)and certain proteins were differentially expressed among the different groups(CCA,pancreatic cancer,PSC or benign).A total of 18 proteins were identified as being more abundant in the malignant group(CCA and pancreatic cancer)than in the benign strictures group,including myeloperoxidase,complement C3,inter-alpha-trypsin inhibitor heavy chain H4,apolipoprotein B-100,and kininogen-1 isoform 2.A total of 30 proteins were identified to be less abundant in the malignant group than in the benign group,including trefoil factor 2,superoxide dismutase[Cu-Zn],kallikrein-1,carboxypeptidase B and trefoil factor 1.Conclusions:Protein biomarkers in bile may differentiate malignant from benign biliary strictures.Larger studies are warranted to validate these observations. | Udayakumar Navaneethan Vennisvasanth Lourdusamy Preethi GK Venkatesh Belinda Willard Madhusudhan R Sanaka Mansour A Parsi | 2015 | Gastroenterology Report2015，3，2： | 0 |
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