Mucosa-associated Lymphoid Tissue Lymphoma of Colon: A Case Report and Literature Review of Rare Entity.

Mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) accounts for approximately 5% of non-Hodgkin lymphomas, and the gastrointestinal (GI) tract is the most common site of involvement. The stomach and small intestine are the most common sites of involvement in the GI tract. Colonic MALT lymphoma is a rare condition that comprises only 2.5% of MALT lymphomas and less than 0.5% of all colon cancers. They usually present as colon mass or polyps. In this case report, we present a case of colonic MALT lymphoma diagnosed on random colon biopsies which is very rare.

ASGE guidelines result in cost-saving in the management of choledocholithiasis.

BACKGROUND: The goal of this study was to determine whether utilization of the ASGE guidelines for the evaluation of bile duct stones (BDS) would result in fewer imaging studies and in turn lead to a lower healthcare expenditure. METHODS: This was a retrospective study set in an urban Teaching Hospital. Patients undergoing evaluation for BDS and who had their gallbladders in situ were included in the study. Data with regard to age, sex, clinical history, pain level, vital signs and laboratory studies as well as diagnostic tests performed were extracted from the hospital's electronic medical record. The ASGE guidelines were applied retrospectively to each patient in the study group and the group was divided into two cohorts: one that followed the ASGE guidelines and one which did not. Patients in the two cohorts were further stratified into high-, intermediate-, and low-risk categories. RESULTS: Thirty-eight patients met the criteria and were included in the study. Of the 38 patients, 22 were managed as per the ASGE guidelines and 16 were not. Twenty-seven patients were categorized as high-risk (14 following the correct algorithm, 13 not) and 11 as intermediate-risk (8 following, 3 not). There were no low-risk patients. Twelve of the 27 patients in the high-risk group had stones (56%) while 6 of 11 (55%) had stones in the intermediate-risk group. Fourteen computed tomography scans and 12 magnetic resonance cholangiopancreatographies were deemed inappropriate resulting in unnecessary increased expenditure of $ 22,236. CONCLUSION: The application of ASGE guidelines can minimize redundant investigations and effect cost saving but need to be refined to produce a better yield.

Tenofovir disoproxil fumarate for prevention of vertical transmission of hepatitis B virus infection by highly viremic pregnant women: a case series.

BACKGROUND: Despite appropriate immunoprophylaxis, up to 10 % of infants born to highly viremic hepatitis B virus (HBV-DNA ≥ 7 log IU/mL) mothers are infected with HBV. Use of TDF to prevent vertical transmission (VT) by such mothers has not been evaluated. PURPOSE: To evaluate the efficacy and safety of TDF in preventing VT from highly viremic HBV-infected mothers. METHODS: Data were collected retrospectively from HBV mono-infected, hepatitis B e antigen (HBeAg) positive, pregnant women between 6/2008 and 11/2010. Cases enrolled were HBV mono-infected mothers who received TDF (300 mg orally once a day) in the third trimester. Those with pregnancy complications or an abnormal fetus on sonography were excluded from use of TDF. All infants received hepatitis B immunoglobulin and vaccination at birth and subsequently. RESULTS: Eleven Asian mothers received TDF at the median gestational age of 29 (28-32) weeks and the median duration of TDF use before delivery was 10 (7-12) weeks. A significant reduction in serum HBV-DNA was achieved at delivery compared with baseline (mean 5.25 ± 1.79 vs. 8.87 ± 0.45 log(10) copies/mL, respectively; p < 0.01). Three had serum ALT levels more than 1.5 times the upper limit of normal and two of these normalized before delivery. The 11 infants were born with no obstetric complication or birth defects. Five infants were breastfed. All infants were hepatitis B surface antigen negative 28-36 weeks after birth. CONCLUSION: Our preliminary data suggest that TDF use in the third trimester is safe, and effectively prevents VT of HBV from high viremic HBeAg-positive mothers.