Black voices in gastroenterology and hepatology.

The Association of Black Gastroenterologists and Hepatologists (ABGH) was established to improve health equity in Black communities and to provide academic and social support for Black gastroenterologists and hepatologists. In this Viewpoint, four members of ABGH (early career, mid-career and late career) discuss their route into gastroenterology and hepatology, how academia and medicine can promote inclusivity and equity, and their advice to Black students interested in a career in medicine or science.

Spice/K2 synthetic marijuana-induced toxic hepatitis treated with N-acetylcysteine.

BACKGROUND: Spice/K2 is one of several street names for synthetic marijuana. These hallucinogens are increasingly sold over the internet and in "head" shops. They are usually household herbs that are sprayed with chemicals that become centrally active compounds when burned together and inhaled by smoking. CASE REPORT: We present a case of a 45-year-old male substance abuser who was admitted with evidence of hepatocellular necrosis and worsening liver failure. Tests for acetaminophen were negative, as were tests for alcohol. The patient was empirically treated with N-acetylcysteine. Hepatocellular damage was abated and the patient made a full recovery. Upon regaining consciousness, the patient admitted to smoking Spice/K2. Other toxicities have been reported with synthetic marijuana use, but not liver toxicity. CONCLUSIONS: Physicians need to have a high index of suspicion for unknown hepatotoxins in substance abusers. N-acetylcysteine can be given if there is no contraindication.

Simultaneous diagnosis of cryptogenic organizing pneumonia and HIV in a 45 year old man.

BACKGROUND: Cryptogenic organizing pneumonia (COP) is a small airways disease characterized by intraluminal polyps of myxoid connective tissue which follows a subclinical course and is associated with infectious as well as non infectious processes The concomitant occurrence of human immunodeficiency virus (HIV) infection and COP has rarely been reported. We describe a unique case in which COP was a presenting feature in a patient with newly diagnosed HIV Infection. CASE REPORT: A 45 year-old man with chronic active smoking presented to the ER with 15 months history of cough productive of minimal whitish sputum without frank or streaks of blood, low grade fever, anorexia and 4-6 lbs weight loss in past 6 months. He had three life time sexual partners. PPD status were unknown. He was extensively worked up as the Chest X ray showed cystic lesions all of which came back normal. Patient also received HIV test which was positive with CD 4 count of 546. He received bronchoscopy which revealed cryptogenic organising pneumonia. He was placed on steroids tapering course which helped in relieving the symptoms. CONCLUSIONS: HIV infection with CD 4 count above 500 has seldom been reported having COP with this case being the second in literature but this entity should be kept in mind during management of these patients.