Featured Publications

Day Care Attendance and Infectious Complications in Children Born to Mothers with Inflammatory Bowel Disease

Long, MD, Siegel, CA, Abraham, BP, Chiorean, M & Mahadevan, U 2022, 'Day Care Attendance and Infectious Complications in Children Born to Mothers With Inflammatory Bowel Disease', Clinical Gastroenterology and Hepatology, vol. 20, no. 3, pp. 706-708.e1. https://doi.org/10.1016/j.cgh.2021.02.003

In utero exposure to biologic therapies for inflammatory bowel disease (IBD) is not associated with adverse pregnancy outcomes or infections in children born to women with IBD, but previous studies have not accounted for the heightened risk of infection in daycare during the child’s first year. Bincy P. Abraham, MD, and colleagues evaluated whether children born to women with IBD and who were exposed to biologic therapy in utero have a higher rate of infection when attending daycare in their first year.

Small Intestinal Bacterial Overgrowth – Pathophysiology and Its Implications for Definition and Management

Bushyhead, D. and Quigley, E.M.M. (2022). Small Intestinal Bacterial Overgrowth, Pathophysiology and its implications for Definition and Management. Gastroenterology. https://doi.org/10.1053/j.gastro.2022.04.002

The concept of Small Intestinal Bacterial Overgrowth (SIBO) emerged in the context of maldigestion and malabsorption in patients with risk factors for injurious bacteria colonizing the small bowel and whose symptoms and laboratory markers could be understood within a coherent pathophysiological framework. The SIBO concept also developed alongside advances in diagnostic testing. Nonetheless, questions remain regarding role of SIBO in the clinical repertoire. Drs. Daniel Bushyhead and Eamonn Quigley review the evidence on SIBO in this paper.

Elevated Hemoglobin A1c Level and Bariatric Surgery Complications

Nwokedi, U, Zia, M, Xu, J, Sadhu, AR, Baio, FE, Kash, BS, Sherman, V & Tariq, N 2022, 'Elevated hemoglobin A1c level and bariatric surgery complications', Surgical Endoscopy. https://doi.org/10.1007/s00464-022-09030-2

Elevated glycosylated hemoglobin (HbA1c) is a modifiable risk factor for complications following cardiac and orthopedic surgery, but in bariatric surgery, there is insufficient evidence to assess the impact of preoperative HbA1c levels on early postoperative outcomes. In a retrospective review of 118,742 patients from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database who underwent bariatric surgery between 2017 and 2018, Vadim Sherman, MD, Nabil Tariq, MD and colleagues found no significant association between elevated HbA1c and postoperative complications. HbA1c levels below 10%, however, were associated with adverse events in this dataset.

Survival Following Liver Transplantation for Locally Advanced, Unresectable Intrahepatic Cholangiocarcinoma

McMillan, RR, Javle, M, Kodali, S, Saharia, A, Mobley, C, Heyne, K, Hobeika, MJ, Lunsford, KE, Victor, DW, Shetty, A, McFadden, RS, Abdelrahim, M, Kaseb, A, Divatia, M, Yu, N, Nolte Fong, J, Moore, LW, Nguyen, DT, Graviss, EA, Gaber, AO, Vauthey, JN & Ghobrial, RM 2022, 'Survival following liver transplantation for locally advanced, unresectable intrahepatic cholangiocarcinoma', American Journal of Transplantation, vol. 22, no. 3, pp. 823-832. https://doi.org/10.1111/ajt.16906

Intrahepatic cholangiocarcinoma (iCCa) was previously considered a contraindication for liver transplantation (LT), but recent case series have shown favorable outcomes for LT after neoadjuvant therapy. In a single-center study of 18 patients who underwent LT following neoadjuvant therapy for locally advanced, unresectable iCCa between 2010 and 2021, David W. Victor III, MD, and colleagues reported 1-, 3-, and 5-year survival rates of 100%, 71%, and 57%, respectively. Seven patients had recurrences and were treated with systemic therapy and resection. These findings support the use of LT as a treatment for highly selected patients with locally advanced, unresectable iCCa.