2021
Novel 15-mm-long lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic fluid collections located ≥10 mm from the luminal wall
Zhang LY, Kunda R, Aerts M, Messaoudi N, Pawa R, Pawa S, Robles-Medranda C, Oleas R, Al-Haddad MA, Obaitan I, Muniraj T, Fabbri C, Binda C, Anderloni A, Tarantino I, Bejjani M, Ghandour B, Singh V, Khashab MA. Novel 15-mm-long lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic fluid collections located ≥10 mm from the luminal wall. Endoscopy 2021, 54: 706-711. PMID: 34905796, DOI: 10.1055/a-1682-7095.Peer-Reviewed Original ResearchConceptsDrainage of PFCsLumen-apposing metal stentsPancreatic fluid collectionsFluid collectionClinical successLuminal wallEndoscopic ultrasound-guided drainageUltrasound-guided drainageEUS-guided drainageLumen-apposing metalPrimary outcomeSecondary outcomesMulticenter studyTechnical successDuodenal wallEndoscopic ultrasoundMaximal diameterMetal stentsLAMS placementComplicationsPatientsRecurrenceOutcomesDrainagePresent outcomesPain Experience in Pancreatitis: Strong Association of Genetic Risk Loci for Anxiety and PTSD in Patients With Severe, Constant, and Constant-Severe Pain
Dunbar EK, Greer PJ, Amann ST, Alkaade S, Banks P, Brand R, Conwell DL, Forsmark CE, Gardner TB, Guda NM, Lewis MD, Machicado JD, Muniraj T, Papachristou GI, Romagnuolo J, Sandhu BS, Sherman S, Slivka A, Wilcox CM, Yadav D, Whitcomb DC, Consortium F. Pain Experience in Pancreatitis: Strong Association of Genetic Risk Loci for Anxiety and PTSD in Patients With Severe, Constant, and Constant-Severe Pain. The American Journal Of Gastroenterology 2021, 116: 2128-2136. PMID: 34236339, PMCID: PMC8531869, DOI: 10.14309/ajg.0000000000001366.Peer-Reviewed Original ResearchConceptsPost-traumatic stress disorderChronic pancreatitisSevere painPain experienceThird of patientsPain management strategiesIdentification of patientsAbsence of painInflammatory syndromePain patternsCP patientsPain categoriesPain locusStudy cohortAcute pancreatitisAdrenal axisCP subjectsPainGenetic predispositionPatientsPsychiatric conditionsGenetic risk lociPTSD riskPancreatitisStress disorderEvaluation of socioeconomic and healthcare disparities on same admission cholecystectomy after endoscopic retrograde cholangiopancreatography among patients with acute gallstone pancreatitis
Chouairi F, McCarty TR, Hathorn KE, Sharma P, Aslanian HR, Jamidar PA, Thompson CC, Muniraj T. Evaluation of socioeconomic and healthcare disparities on same admission cholecystectomy after endoscopic retrograde cholangiopancreatography among patients with acute gallstone pancreatitis. Surgical Endoscopy 2021, 36: 274-281. PMID: 33481109, DOI: 10.1007/s00464-020-08272-2.Peer-Reviewed Original ResearchConceptsSame-admission cholecystectomyAcute gallstone pancreatitisEndoscopic retrograde cholangiopancreatographyCharlson Comorbidity IndexGallstone pancreatitisRetrograde cholangiopancreatographyU.S. Nationwide Inpatient Sample (NIS) databaseHigher Charlson comorbidity indexNationwide Inpatient Sample databaseMedicare payer statusUrban-teaching hospitalsMajority of patientsMultivariable logistic regressionRace/ethnicitySocio-demographic factorsHospital mortalityComorbidity indexHospital stayPayer statusSurgical managementHospitalization costsResultsA totalBlack raceTreatment strategiesFemale gender
2020
Endoscopic ultrasound‐guided fine needle aspiration cytology diagnosis of upper gastrointestinal tract mesenchymal tumors: Impact of rapid onsite evaluation and correlation with histopathologic follow‐up
Gilani SM, Muniraj T, Aslanian HR, Cai G. Endoscopic ultrasound‐guided fine needle aspiration cytology diagnosis of upper gastrointestinal tract mesenchymal tumors: Impact of rapid onsite evaluation and correlation with histopathologic follow‐up. Diagnostic Cytopathology 2020, 49: 203-210. PMID: 33006819, DOI: 10.1002/dc.24631.Peer-Reviewed Original ResearchConceptsRapid onsite evaluationSubsequent surgical resectionUpper gastrointestinal tractMesenchymal tumorsSurgical resectionCell blocksEUS-FNAFine needle aspiration cytology diagnosisUltrasound-guided fine-needle aspiration cytologyEndoscopic ultrasound-guided fine-needle aspiration cytologyFine needle aspiration cytologyOnsite evaluationAdditional ancillary testingNeedle aspiration cytologyDiagnostic challengeCytologic casesDiagnostic yieldAncillary testingAspiration cytologyCytologic diagnosisGastrointestinal tractMorphologic overlapCytology diagnosisElectronic databasesLesional materialThe Reply
Lam R, Jamidar PA, Aslanian HR, Muniraj T. The Reply. The American Journal Of Medicine 2020, 133: e612. PMID: 33004185, DOI: 10.1016/j.amjmed.2020.05.048.Peer-Reviewed Original ResearchLow serum trypsinogen levels in chronic pancreatitis: Correlation with parenchymal loss, exocrine pancreatic insufficiency, and diabetes but not CT-based cambridge severity scores for fibrosis
Zhan W, Akshintala V, Greer PJ, Greer JB, Alkaade S, Anderson MA, Muniraj T, Papachristou GI, Sandhu BS, Slivka A, Wilcox CM, Bellin MD, Singh VK, Yadav D, Brand RE, Whitcomb DC, Group F. Low serum trypsinogen levels in chronic pancreatitis: Correlation with parenchymal loss, exocrine pancreatic insufficiency, and diabetes but not CT-based cambridge severity scores for fibrosis. Pancreatology 2020, 20: 1368-1378. PMID: 32967795, DOI: 10.1016/j.pan.2020.08.025.Peer-Reviewed Original ResearchConceptsSerum trypsinogen levelsChronic pancreatitisTrypsinogen levelsAcinar cell functionCP patientsParenchymal lossCell functionComplex inflammatory disorderExocrine pancreatic insufficiencyCT-based criteriaNAPS2 studySerum trypsinogenAcinar cell lossSurgical resectionFinal cohortInflammatory cellsInflammatory disordersControl subjectsSeverity scoreClinical managementPancreatic insufficiencyStellate cellsNormal rangeCell lossIslet cellsConstant-severe pain in chronic pancreatitis is associated with genetic loci for major depression in the NAPS2 cohort
Dunbar E, Greer PJ, Melhem N, Alkaade S, Amann ST, Brand R, Coté GA, Forsmark CE, Gardner TB, Gelrud A, Guda NM, LaRusch J, Lewis MD, Machicado JD, Muniraj T, Papachristou GI, Romagnuolo J, Sandhu BS, Sherman S, Wilcox CM, Singh VK, Yadav D, Whitcomb DC. Constant-severe pain in chronic pancreatitis is associated with genetic loci for major depression in the NAPS2 cohort. Journal Of Gastroenterology 2020, 55: 1000-1009. PMID: 32681239, PMCID: PMC9124361, DOI: 10.1007/s00535-020-01703-w.Peer-Reviewed Original ResearchConceptsConstant severe painRecurrent acute pancreatitisChronic pancreatitisDepression-associated genesCP patientsPain severityAntidepressant usePancreatitis patientsPain experienceProspective randomized trialsAntidepressant medication usePattern of painCase report formsChronic opioidsIslet autotransplantationAntidepressant therapyTotal pancreatectomyMedication usePain managementRandomized trialsCounseling patientsRetrospective studyAcute pancreatitisClinical trialsMajor depressionEndoscopic ultrasound (EUS) and the management of pancreatic cancer
Yousaf MN, Chaudhary FS, Ehsan A, Suarez AL, Muniraj T, Jamidar P, Aslanian HR, Farrell JJ. Endoscopic ultrasound (EUS) and the management of pancreatic cancer. BMJ Open Gastroenterology 2020, 7: e000408. PMID: 32414753, PMCID: PMC7232396, DOI: 10.1136/bmjgast-2020-000408.Peer-Reviewed Original ResearchMeSH KeywordsCarcinoma, Pancreatic DuctalCholangiopancreatography, Endoscopic RetrogradeEarly DiagnosisEndosonographyFemaleGastroenterologyHumansInterdisciplinary CommunicationMaleMedical OncologyPancreatic NeoplasmsPatient Care ManagementPrevalenceRadiologyRandomized Controlled Trials as TopicSensitivity and SpecificityStentsSurgical OncologyConceptsManagement of patientsPancreatic cancerEndoscopic ultrasoundIdentification of patientsCancer-related mortalityPancreatic ductal adenocarcinomaSurgical candidatesMedical oncologyPancreatic malignancyDuctal adenocarcinomaRadiological imagingTherapeutic roleSurgical oncologyDiagnostic evaluationEarly diagnosisMultidisciplinary involvementInterventional endoscopyCancerPatientsWestern countriesOncologyManagementAdenocarcinomaMalignancyEndoscopyEndoscopic ultrasound‐guided fine needle aspiration of accessory spleen: Cytomorphologic features and diagnostic considerations
Gilani SM, Muniraj T, Farrell JJ, Aslanian HR, Cai G. Endoscopic ultrasound‐guided fine needle aspiration of accessory spleen: Cytomorphologic features and diagnostic considerations. Diagnostic Cytopathology 2020, 48: 623-628. PMID: 32315514, DOI: 10.1002/dc.24434.Peer-Reviewed Original ResearchConceptsEndoscopic ultrasound-guided fine-needle aspirationUltrasound-guided fine-needle aspirationFine-needle aspirationProminent vascularityLymphoid cellsLarge platelet aggregatesCytomorphologic featuresNeedle aspirationNeoplastic processNon-specific clinical symptomsKey cytomorphologic featuresMass-forming lesionsPancreatic tail regionMixed inflammatory cellsKey cytologic featuresSmall-sized lymphocytesPancreas/Most patientsMale patientsSurgical managementClinical symptomsInflammatory cellsMean agePeripancreatic tissueDiagnostic challengeFitz-Hugh-Curtis Syndrome Presenting as Acute Abdomen
Lam R, Jamidar PA, Aslanian HR, Muniraj T. Fitz-Hugh-Curtis Syndrome Presenting as Acute Abdomen. The American Journal Of Medicine 2020, 133: e596. PMID: 32277885, DOI: 10.1016/j.amjmed.2020.02.037.Peer-Reviewed Original ResearchMusculoskeletal Pain Symptoms and Injuries Among Endoscopists Who Perform ERCP
Campbell EV, Muniraj T, Aslanian HR, Laine L, Jamidar P. Musculoskeletal Pain Symptoms and Injuries Among Endoscopists Who Perform ERCP. Digestive Diseases And Sciences 2020, 66: 56-62. PMID: 32144599, DOI: 10.1007/s10620-020-06163-z.Peer-Reviewed Original ResearchConceptsEndoscopic retrograde cholangiopancreatographyMusculoskeletal pain symptomsPain symptomsRisk factorsMusculoskeletal injuriesPrevalent musculoskeletal injuriesDe Quervain's tenosynovitisPotential risk factorsRisk of injuryAnonymous electronic surveyNeck painBack painQuervain's tenosynovitisRetrograde cholangiopancreatographyResultsA totalPreventative strategiesConclusionsThe majorityInjurySymptomsEndoscopistsProtective gearMultiple studiesHalf reportTenosynovitisElectronic survey
2019
Genetic Risk Score in Diabetes Associated With Chronic Pancreatitis Versus Type 2 Diabetes Mellitus
Goodarzi MO, Nagpal T, Greer P, Cui J, Chen YI, Guo X, Pankow JS, Rotter JI, Alkaade S, Amann ST, Baillie J, Banks PA, Brand RE, Conwell DL, Cote GA, Forsmark CE, Gardner TB, Gelrud A, Guda N, LaRusch J, Lewis MD, Money ME, Muniraj T, Papachristou GI, Romagnuolo J, Sandhu BS, Sherman S, Singh VK, Wilcox CM, Pandol SJ, Park WG, Andersen DK, Bellin MD, Hart PA, Yadav D, Whitcomb DC. Genetic Risk Score in Diabetes Associated With Chronic Pancreatitis Versus Type 2 Diabetes Mellitus. Clinical And Translational Gastroenterology 2019, 10: e00057. PMID: 31232720, PMCID: PMC6708663, DOI: 10.14309/ctg.0000000000000057.Peer-Reviewed Original ResearchConceptsGenetic risk scoreDiabetes mellitusChronic pancreatitisCP-DMPancreatogenic diabetesRisk scoreNorth American Pancreatitis Study 2Type 2 diabetes mellitusLarge prospective studiesSingle nucleotide polymorphismsMulti-Ethnic StudyWeighted genetic risk scoreMean genetic risk scoreDiabetic groupNondiabetic controlsProspective studyNucleotide polymorphismsPathophysiologic entityFamily historyT2DMDiabetesType 2Separate disordersGold standardMellitusChronic Pancreatitis
Schwarzenberg SJ, Uc A, Zimmerman B, Wilschanski M, Wilcox CM, Whitcomb DC, Werlin SL, Troendle D, Tang G, Slivka A, Singh VK, Sherman S, Shah U, Sandhu BS, Romagnuolo J, Rhee S, Pohl JF, Perito ER, Ooi CY, Nathan JD, Muniraj T, Morinville VD, McFerron B, Mascarenhas M, Maqbool A, Liu Q, Lin TK, Lewis M, Husain SZ, Himes R, Heyman MB, Guda N, Gonska T, Giefer MJ, Gelrud A, Gariepy CE, Gardner TB, Freedman SD, Forsmark CE, Fishman DS, Cote GA, Conwell D, Brand RE, Bellin M, Barth B, Banks PA, Anderson MA, Amann ST, Alkaade S, Abu‐El‐Haija M, Abberbock JN, Lowe ME, Yadav D. Chronic Pancreatitis. Journal Of Pediatric Gastroenterology And Nutrition 2019, 68: 566-573. PMID: 30897605, PMCID: PMC6492264, DOI: 10.1097/mpg.0000000000002279.Peer-Reviewed Original ResearchConceptsChronic pancreatitisRisk factorsGenetic risk factorsOnly risk factorEmergency room visitsInternational Study GroupAge of onsetWork/schoolDisease durationPediatric pancreatitisRoom visitsDiabetes prevalenceRadiographic findingsAppropriate statistical testsPancreatic insufficiencyChildhood onsetStudy groupSecondary analysisCohortNatural historyPancreatitisCP treatmentAdultsChildrenLength of timeIncreased awareness enhances physician recognition of the role of smoking in chronic pancreatitis
Muniraj T, Yadav D, Abberbock JN, Alkaade S, Amann ST, Anderson MA, Banks PA, Brand RE, Conwell D, Cote GA, Forsmark CE, Gardner TB, Gelrud A, Guda N, Lewis MD, Romagnuolo J, Sandhu BS, Sherman S, Singh VK, Slivka A, Tang G, Whitcomb DC, Wilcox CM. Increased awareness enhances physician recognition of the role of smoking in chronic pancreatitis. Pancreatology 2019, 19: 500-506. PMID: 30910452, PMCID: PMC6619496, DOI: 10.1016/j.pan.2019.02.009.Peer-Reviewed Original ResearchConceptsCP risk factorsPack/dayRisk factorsPhysician recognitionSmoking statusAS studiesIdentification of smokingPancreatitis risk factorsRole of smokingRisk of CPPhysician questionnairesStructured patientAlcohol etiologyCP patientsPast smokersChronic pancreatitisMultivariable analysisSmoking ratesUS CentersSmokingEmpiric dataPatientsPhysiciansWide-spread disseminationEtiologyPerforation of the duodenum 2 weeks after lumen-apposing metal stent placement for malignant pyloric stricture
Muniraj T, Salem R, Olave-Martinez M, Suarez A, Aslanian HR. Perforation of the duodenum 2 weeks after lumen-apposing metal stent placement for malignant pyloric stricture. Gastrointestinal Endoscopy 2019, 89: 1069-1070. PMID: 30639540, DOI: 10.1016/j.gie.2019.01.006.Peer-Reviewed Original Research
2018
AGA Clinical Practice Guidelines on the Management of Mild-to-Moderate Ulcerative Colitis
Ko C, Singh S, Feuerstein J, Falck-Ytter C, Falck-Ytter Y, Cross R, Committee A, Crockett S, Falck-Ytter Y, Feuerstein J, Flamm S, Inadomi J, Ko C, Muniraj T, O’Shea R, Pandolfino J, Patel A, Sharaf R, Siddique S, Su G, Wang K, Weizman A. AGA Clinical Practice Guidelines on the Management of Mild-to-Moderate Ulcerative Colitis. Gastroenterology 2018, 156: 748-764. PMID: 30576644, PMCID: PMC6858922, DOI: 10.1053/j.gastro.2018.12.009.Peer-Reviewed Original ResearchCannabis Use Is Associated With Increased Risk of Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis
Njei B, Sharma P, McCarty TR, Singh M, Haque L, Aslanian HR, Jamidar P, Muniraj T. Cannabis Use Is Associated With Increased Risk of Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis. Pancreas 2018, 47: 1142-1149. PMID: 30134357, DOI: 10.1097/mpa.0000000000001143.Peer-Reviewed Original ResearchConceptsPost-endoscopic retrograde cholangiopancreatography pancreatitisIncidence risk ratioCholangiopancreatography pancreatitisCannabis useRisk of PEPEndoscopic retrograde cholangiopancreatography pancreatitisUS Nationwide Inpatient SampleRate of PEPShorter hospital stayNationwide Inpatient SampleNinth Edition codesImpact of cannabisPoisson regression modelsHospital deathHospital stayIndependent predictorsEdition codesRisk ratioInpatient SampleInternational ClassificationMultivariate analysisPancreatitisPatientsCannabisSignificant increaseNutrition and Inflammatory Biomarkers in Chronic Pancreatitis Patients
Greer JB, Greer P, Sandhu BS, Alkaade S, Wilcox CM, Anderson MA, Sherman S, Gardner TB, Lewis MD, Guda NM, Muniraj T, Conwell D, Cote GA, Forsmark CE, Banks PA, Tang G, Stello K, Gelrud A, Brand RE, Slivka A, Whitcomb DC, Yadav D. Nutrition and Inflammatory Biomarkers in Chronic Pancreatitis Patients. Nutrition In Clinical Practice 2018, 34: 387-399. PMID: 30101991, PMCID: PMC6642676, DOI: 10.1002/ncp.10186.Peer-Reviewed Original ResearchConceptsC-reactive proteinCP patientsChronic pancreatitis patientsSerum prealbuminVitamin APancreatitis patientsVitamin supplementsHigher C-reactive proteinPancreatic enzyme replacement therapyInflammatory marker levelsPancreatic enzyme replacementSubset of patientsBody mass indexHigher serum levelsBone metabolism biomarkersTumor necrosis factorEnzyme replacement therapyLow levelsComorbid diabetesInflammatory biomarkersDiabetes mellitusSerum levelsMass indexPrimary etiologyReplacement therapyBarrett's esophagus: A comprehensive review for the internist
Klavan H, Russell MB, Macklin J, Lee E, Aslanian HR, Muniraj T. Barrett's esophagus: A comprehensive review for the internist. Disease-a-Month 2018, 64: 471-487. PMID: 29880269, DOI: 10.1016/j.disamonth.2018.04.001.Peer-Reviewed Original ResearchRecurrent Acute Pancreatitis Significantly Reduces Quality of Life Even in the Absence of Overt Chronic Pancreatitis
Coté GA, Yadav D, Abberbock JA, Whitcomb DC, Sherman S, Sandhu BS, Anderson MA, Lewis MD, Alkaade S, Singh VK, Baillie J, Banks PA, Conwell D, Guda NM, Muniraj T, Tang G, Brand R, Gelrud A, Amann ST, Forsmark CE, Wilcox C, Slivka A, Gardner TB. Recurrent Acute Pancreatitis Significantly Reduces Quality of Life Even in the Absence of Overt Chronic Pancreatitis. The American Journal Of Gastroenterology 2018, 113: 906-912. PMID: 29867178, PMCID: PMC6136830, DOI: 10.1038/s41395-018-0087-7.Peer-Reviewed Original ResearchConceptsMental component summary scoresRecurrent acute pancreatitisLower physical component summaryPhysical component summaryQuality of lifeChronic pancreatitisAcute pancreatitisLower mental component summary scoresMental QOLLower QOLShort Form-12Component summary scoresCross-sectional studyMultivariable regression modelsNon-disease controlsEndocrine insufficiencyComponent summaryIndependent predictorsForm-12CP subjectsPancreatitisSummary scoresObjectivesThe impactU.S. CentersQOL predictors