Diagnostic yield of bidirectional endoscopy for iron deficiency anemia in young patients.

BACKGROUND: While bidirectional endoscopy is recognized as the standard approach for investigating iron deficiency anemia (IDA) in men older than 45 and postmenopausal women, evidence supporting the application of this approach in younger men and premenopausal women is scarce in the absence of symptoms. Our primary aim is to identify the diagnostic yield of bidirectional endoscopy in men younger than 45 and premenopausal women, and describe the clinical characteristics of those with significant endoscopic and pathology-proven findings. METHODS: We performed a retrospective chart review including patients younger than age 45 with IDA who underwent esophagogastroduodenoscopy (EGD) and/or colonoscopy at the Brooklyn VA Hospital between 2009 and 2023. Demographic, clinical, and endoscopic patient data was all collected, stratified, analyzed, and interpreted. RESULTS: In 143 patients younger than age 45 with IDA, 28.6% were found to have positive upper gastrointestinal (GI) findings, of which 70.3% were pathology-proven H. pylori cases. 57.9% of patients reported upper GI symptoms, while 42.9% of patients were asymptomatic. In total, 18.2% of symptomatic patients were found to have clinically significant findings on EGD as compared with 42.9% of asymptomatic patients. Additionally, 9.1% of symptomatic patients were found to have biopsy proven H. pylori-associated gastritis or duodenitis as compared with 33.9% of asymptomatic patients. Of the patients who underwent colonoscopy, 8.3% were found to have lower GI lesions. CONCLUSIONS: We found the diagnostic yield of EGD to be significantly higher than that of colonoscopy in younger IDA patients. Our findings suggest current guidelines are clinically relevant to the young patient cohort. Our study also found asymptomatic IDA patients below age 45 to have a significantly higher diagnostic yield of EGD as compared to symptomatic IDA patients within the same age cohort. The differences in diagnostic yields may be a result of symptomatic patients being more likely to have been prescribed proton pump inhibitors or histamine receptor antagonists prior to endoscopy.

Ultrarapid Development of Ruptured Esophageal Varices in a Patient With a History of Heller Myotomy.

Esophageal varices commonly affect cirrhotic patients as a result of elevated portal system resistance. Blood pools within esophageal portosystemic collateral vessels, which can eventually rupture, leading to life-threatening hemorrhage. To prevent this, cirrhotic patients without a history of varices undergo endoscopic surveillance for varices every 2-3 years. We present an unusual case of variceal hemorrhage in a patient who was seen to have no varices on endoscopic evaluation only a month earlier.

Retrograde Migration of a Percutaneous Endoscopic Gastro-Jejunal Tube Into the Esophagus.

Percutaneous endoscopic gastrostomy (PEG) and percutaneous endoscopic gastro-jejunal (PEG-J) tube placement are both common procedures regularly performed on patients requiring nutritional support. These procedures may be complicated by infection, hemorrhage, fistulization, or tube migration. We present an extremely rare case of a patient with a PEG-J tube that migrated into the esophagus.

A bibliometric analysis of the 50 most influential publications on distal biceps repair.

PURPOSE: The purpose of this bibliometric study was to identify and analyze the most cited publications on acute distal biceps repair. METHODS: Using the Clarivate Analytics Web of Science database, we searched for the top 50 most cited publications on acute distal biceps repair and analyzed them based on various metrics. RESULTS: The top 50 publications were cited a total of 3171 times and approximately 151 times per year. However, although the literature on the topic is quite extensive, most publications only contain low-level evidence. In fact, 74% of the 50 most cited publications on the topic contain either level IV or V evidence. CONCLUSION: This study, through bibliometric analysis, demonstrates that the most often cited studies about acute distal biceps tendon repair are low level of evidence designs. This common injury and study design are ripe for larger randomized or prospective cohort studies.

Application of SCAR markers linked with mungbean yellow mosaic virus disease-resistance gene in Pakistan mungbean germplasm.

Mungbean yellow mosaic virus disease (MYMVD) caused by single-stranded DNA begomovirus is the most prominent threat to the mungbean crop in Pakistan. Mungbean genotypes consisting of 127 varieties/lines were screened for MYMVD under natural field conditions. No genotypes were found to be immune or highly resistant against MYMVD. Genotypes showing resistant and tolerant responses in field screening trials were screened using sequence characterized amplified region (SCAR) markers linked with the MYMVD-resistance gene. SCAR markers amplified the desired band only in the resistant and tolerant genotypes, while no amplification was observed in susceptible genotypes. SCAR markers will be useful for future breeding and varietal developmental programs and mungbean genotypes can be screened on the molecular level.

Molecular characterization of urdbean (Vigna mungo) germplasm related to resistance against urdbean leaf crinkle virus.

Urdbean (Vigna mungo) is an important pulse crop grown worldwide. Urdbean leaf crinkle virus (ULCV) is a pathogen of urdbean found in Pakistan that causes huge losses in yield. Forty urdbean varieties/lines were screened against the virus under field conditions during spring season 2009. None of the lines appeared to be highly resistant or resistant. On the basis of a 0-5 disease rating scale and disease severity index, genotypes varied significantly in their reaction to ULCV. Four lines (M-6206, IAM-382-15, IAM-133, and Mash-1) were moderately resistant, eight were rated as moderately susceptible, and 21 as susceptible; the remaining seven lines were highly susceptible. RAPD analyses revealed an extensive amount of variation, which could be used for cultivar identification. Genetic differentiation among urdbean genotypes was similar to the field screening data. The varieties 6065-3 and 6206 were highly susceptible and moderately resistant, respectively, to ULCV under field conditions, confirmed by the RAPD analysis. These varieties were the most diverse varieties in the similarity matrix (67.2%), while the varieties IAM-382-9 and 07M003 were the most similar (98.4%). This information will help in the recognition of available resistant germplasms that can resist this disease and will be utilized for urdbean improvement in Pakistan.