• Engberg Kehoe posted an update 1 week ago

    While the trendline of these death rate curves meet the curve of current ratio between accumulative death cases and confirmed cases at some points in the near future, we considered that these intersections are within the range of real death rates. Six tables were presented to illustrate the PIBA method using data from China and South Korea. One figure on estimated rate of infection and patients in serious condition and retrospective estimation of initially occurring time of CORID-19 based on PIBA. © 2020 Published by Elsevier Inc.Human cadaver dissection remains a core and preferred method of anatomical instruction at most low- and middle-income health professional training institutions. Dissection, which is both traumatic and stressful, sets the tone of the students’ responses to later and or similar stressful learning opportunities like the post-mortems or care for terminally ill patients. Partial least squares structural equation modelling was used to determine the effect of the students’ personality, perception of the learning environment, learning approach, and effect of the environment on the student, on undergraduate health professional student’s activity in the human cadaver dissection room. This was a secondary analysis of previously collected data from a cross sectional survey of undergraduate health professional students. We found that personality type and perception of the environment had a positive effect on dissection room activity. Approach to learning and being affected by the dissection room experience (impact), had a negative effect on dissection room activity. All the above effects on dissection room activity were not significant. This study showed that personality, perception of the learning environment, learning approach and effect of the environment on the student, had effects on undergraduate health professional student’s activity in the human cadaver dissection room. The modelled effects are opportunities for educational interventions aimed at increasing student activity in the dissection room.Malignant esophageal strictures often require stent placement to alleviate dysphagia and improve quality of life. We present a novel application of a lumen-apposing metal stent to bypass a malignant esophageal stricture in the setting of altered gastric anatomy. © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.A 21-year-old man from India presented with acute hepatitis associated with a 1-week history of abdominal pain, pruritus, and dark urine. Over a 7-day admission, the patient’s acute hepatitis evolved into acute liver failure with low-grade encephalopathy, markedly elevated transaminases, bilirubin, and impaired hepatic synthetic function. He was eventually diagnosed with acute hepatitis E virus (HEV) and was transitioned to supportive management. Acute HEV is a rare cause of acute liver failure. Hence, this case highlights the importance of early consideration of HEV in all patients with acute hepatitis who have originated from endemic regions. © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.Bronchogenic cysts belong in the category of foregut duplication cysts, along with esophageal and neuroenteric duplication cysts. They are often found incidentally on cross-sectional imaging. Although they are benign, patients often undergo surgical resection because of diagnostic uncertainties. We report the first case of bronchogenic cyst diagnosed with the microforceps, after previous nondiagnostic fine-needle aspirations, thus allowing the patient to avoid surgery. © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. 8Cyclopentyl1,3dimethylxanthine on behalf of The American College of Gastroenterology.Hirschsprung’s disease (HSCR) is a congenital defect caused by impaired development of the enteric nervous system. Inflammatory bowel disease has an increased prevalence in patients with HSCR. We describe the clinical course of a patient with long-segment HSCR who, at the age of 12 months, developed diffuse intestinal inflammation most clinically consistent with very early onset inflammatory bowel disease. We further explore previous studies that implicate the underlying neuroenteric abnormalities in HSCR as possible explanations for this patient’s intestinal immune and inflammatory dysregulation. © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.Budd-Chiari syndrome may rarely occur as a complication of Behcet’s disease, and presentation with thrombosis of both inferior vena cava (IVC) and hepatic veins is rarer still. We present a young woman with Behcet’s disease who presented with acute Budd-Chiari syndrome, with thrombosis of IVC and all 3 hepatic veins. An IVC stent was placed, followed by a transjugular intrahepatic portosystemic shunt through the IVC stent. On follow-up, despite oral anticoagulants and oral steroids, she developed recurrent thrombosis twice within a 1-year span. Her symptoms resolved with stent revision and increasing immunosuppression. © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.Cholestatic hepatitis has not been reported as a paraneoplastic syndrome of endometrial adenocarcinoma to our knowledge. We present a patient who, shortly after endometrial adenocarcinoma diagnosis, presented with elevated liver chemistries in the setting of an acute, paraneoplastic sensorimotor polyneuropathy. Infectious, autoimmune, pharmacologic, malignant, metabolic, and structural causes of cholestatic hepatitis were screened for and ruled out. Our patient was diagnosed with simultaneous cholestatic hepatitis and acute sensorimotor polyneuropathy as possible paraneoplastic syndromes of endometrial adenocarcinoma. Clinicians should include paraneoplastic processes of cancer in the differential diagnosis for liver injury, especially when workup for alternative causes is unrevealing. © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.