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Editorial
Surgery or Medical Therapy for Obese Patients with Type 2 Diabetes?
Type 2 diabetes is one of the fastest growing epidemics in human history and is closely associated with obesity. Furthermore, the disease has multiple manifestations and is associated with progressive beta-cell failure. Although lifestyle measures, including weight loss and physical activity,…
- April 26, 2012
- Zimmet P. and Alberti K.G.M.M.
- N Engl J Med 2012; 366:1635-1636
Type 2 diabetes is one of the fastest growing epidemics in human history and is closely associated with obesity.¹ Furthermore, the disease has multiple manifestations and is associated with progressive beta-cell failure.² Although lifestyle measures, ...
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Original Article
Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes
The growing incidence of obesity and type 2 diabetes mellitus globally is widely recognized as one of the most challenging contemporary threats to public health. Uncontrolled diabetes leads to macrovascular and microvascular complications, including myocardial infarction, stroke, blindness,…
- April 26, 2012
- Schauer P.R., Kashyap S.R., Wolski K., et al.
- N Engl J Med 2012; 366:1567-1576
- CME
In this randomized, controlled study of obese patients with type 2 diabetes, those who received medical therapy plus bariatric surgery had significantly better glycemic control at 12 months than did those who received medical therapy alone.
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Images in Clinical Medicine
Pneumoperitoneum
Figure 1.
- April 26, 2012
- Ailon J.
- N Engl J Med 2012; 366:e26
- Free Full Text
A 69-year-old woman presented to the emergency department with a 3-day history of progressively worsening abdominal distention and pain. She was taking dexamethasone for cerebral edema associated with glioblastoma multiforme.
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Original Article
Low-Dose Abdominal CT for Evaluating Suspected Appendicitis
Owing to the many advantages that computed tomography (CT) has over other diagnostic tests, including ultrasonography,– CT has assumed a paramount position in the evaluation of adults with suspected appendicitis. Despite historical debate, the increased use of CT has been consistently found to…
- April 26, 2012
- Kim K., Kim Y.H., Kim S.Y., et al.
- N Engl J Med 2012; 366:1596-1605
- CME
In this randomized trial involving young adults with suspected appendicitis, low-dose abdominal computed tomography (CT) was noninferior to standard-dose abdominal CT, with similar rates of negative appendectomy and appendiceal perforation in the two study groups.
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Original Article
Familial Diarrhea Syndrome Caused by an Activating GUCY2C Mutation
Chronic diarrhea is a health problem that poses challenges with respect to both diagnosis and treatment. The irritable bowel syndrome affects 15 to 20% of adults and is a common cause of diarrhea. Other causes include inflammatory bowel disease, infections, paraneoplastic hormones, celiac disease,…
- April 26, 2012
- Fiskerstrand T., Arshad N., Haukanes B.I., et al.
- N Engl J Med 2012; 366:1586-1595
Heat-stable enterotoxin induces diarrhea by activating guanylate cyclase (GC-C) on enterocytes, resulting in the secretion of water into the intestinal lumen. This study shows that an activating mutation affecting GC-C also produces this effect.
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Original Article
Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes
The prevalence of type 2 diabetes mellitus is rapidly increasing worldwide, in parallel with the current obesity epidemic. In 2010, the global prevalence of type 2 diabetes was estimated at 8.3% of the adult population, a proportion that is projected to increase to 9.9% by 2030. As many as 23% of…
- April 26, 2012
- Mingrone G., Panunzi S., De Gaetano A., et al.
- N Engl J Med 2012; 366:1577-1585
In this study involving severely obese patients with type 2 diabetes, Roux-en-Y gastric bypass and biliopancreatic diversion achieved better glucose control than conventional medical therapy as assessed at 2 years.
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Case Records of the Massachusetts General Hospital
Case 12-2012 — A 10-Month-Old Girl with Vomiting and Episodes of Unresponsiveness
Presentation of Case. Dr. Helen H. Yeung (Pediatrics): A 10-month-old girl was seen in the emergency department at this hospital because of vomiting and episodes of unresponsiveness. The patient had been well until 2 a.m. on the day of admission, when she awoke with vomiting that was associated…
- April 19, 2012
- Sassower K.C., Allister L.M., Westra S.J.
- N Engl J Med 2012; 366:1527-1536
- CME
A 10-month-old girl was seen in the emergency department because of vomiting and episodes of unresponsiveness, which had begun suddenly 7 hours earlier. She gradually became somnolent. Vital signs, a physical examination, and brain imaging were normal.
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Images in Clinical Medicine
Achalasia
Figure 1.
- April 12, 2012
- Jafferbhoy S. and Rustum Q.
- N Engl J Med 2012; 366:e23
- Free Full Text
A 43-year-old woman presented to the surgical clinic with an 8-month history of weight loss and progressive dysphagia to solids and liquids. She also had dyspepsia and depression.
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Original Article
A Randomized Trial of Rectal Indomethacin to Prevent Post-ERCP Pancreatitis
Acute pancreatitis is the most common major complication of endoscopic retrograde cholangiopancreatography (ERCP), accounting for substantial morbidity, occasional death, and estimated health care expenditures of approximately $150 million annually in the United States. Given the magnitude of this…
- April 12, 2012
- Elmunzer B.J., Scheiman J.M., Lehman G.A., et al.
- N Engl J Med 2012; 366:1414-1422
In this trial involving patients at increased risk for pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP), rectal indomethacin reduced the incidence of this condition, as compared with placebo (9% vs. 17%).
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Images in Clinical Medicine
Intestinal Infestation with Ancylostoma ceylanicum
Figure 1.
- March 29, 2012
- Hsu Y.-C. and Lin J.-T.
- N Engl J Med 2012; 366:e20
- Free Full Text
- Video
Under magnifying endoscopy, a worm is seen hooking its head into the intestinal mucosa. The parasite was removed and identified as Ancylostoma ceylanicum, a nematode that is endemic to Southeast Asia.
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Case Records of the Massachusetts General Hospital
Case 10-2012 — A 16-Year-Old Boy with Epigastric Pain and a Mediastinal Mass
Presentation of Case. Dr. Jennifer C. Hensley (Pediatrics): A 16-year-old boy was admitted to this hospital because of abdominal pain and a mediastinal mass. The patient had been well until 4 days before admission, when he began to feel vaguely ill. The next day, nonbloody emesis occurred. Two days…
- March 29, 2012
- Kelleher C.M., Forcione D.G., Gee M.S., Mino-Kenudson M.
- N Engl J Med 2012; 366:1241-1249
- Video
A 16-year-old boy was admitted to this hospital because of abdominal pain for 2 days. On examination, there was epigastric tenderness with guarding. Imaging revealed a posterior mediastinal cystic mass. Diagnostic procedures were performed.
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Images in Clinical Medicine
Eruptive Xanthoma
Figure 1.
- March 1, 2012
- Kala J. and Mostow E.N.
- N Engl J Med 2012; 366:835
- Free Full Text
A 30-year-old woman with diabetes who had poor glucose control, hypertension, and hyperlipidemia was referred for evaluation of a rash of 1 month's duration. She reported no fevers, chills, or joint pain, nor had she taken glucocorticoids or had contact with anyone with similar symptoms.
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Editorial
Challenges Facing JAK Inhibitor Therapy for Myeloproliferative Neoplasms
William Vainchenker discovered the gain-of-function mutation in the gene encoding Janus kinase (JAK) 2 (JAK2 V617F) in early 2004 (reported in 2005) and subsequently described its association with BCR-ABL1–negative myeloproliferative neoplasms and its ability to induce erythrocytosis in mice. At…
- March 1, 2012
- Tefferi A.
- N Engl J Med 2012; 366:844-846
William Vainchenker discovered the gain-of-function mutation in the gene encoding Janus kinase (JAK) 2 (JAK2 V617F) in early 2004 (reported in 2005)¹ and subsequently described its association with BCR-ABL1–negative myeloproliferative neoplasms and its ...
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Images in Clinical Medicine
Sigmoid Perforation in Association with Colonoscopy
Figure 1.
- February 23, 2012
- Lu A. and Aronowitz P.
- N Engl J Med 2012; 366:744
- Free Full Text
A 74-year-old woman was undergoing a screening colonoscopy when it became apparent that the rectosigmoid junction might have become perforated. The procedure was terminated, and radiographs were obtained.
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Review Article
Mechanisms of Disease: IgG4-Related Disease
IgG4-related disease is a newly recognized fibroinflammatory condition characterized by tumefactive lesions, a dense lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, storiform fibrosis, and, often but not always, elevated serum IgG4 concentrations. The disease was not recognized as…
- February 9, 2012
- Stone J.H., Zen Y., Deshpande V.
- N Engl J Med 2012; 366:539-551
A number of autoimmune diseases that affect diverse organ systems have recently been noted to be related to IgG4 autoantibodies. The authors review the spectrum of IgG4-related disease and the current status of diagnostic and management approaches.
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Clinical Problem-Solving
Worth a Second Look
Foreword. In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows. Stage. A 72-year-old man presented to his…
- February 2, 2012
- Berzin T.M., Greenberger N.J., Levy B.D., Loscalzo J.
- N Engl J Med 2012; 366:463-468
A 72-year-old man presented to his physician for evaluation of fatigue and weight loss. Over the previous 8 months, the patient had lost 16 kg (35 lb) and had begun having up to 10 loose stools per day. There was no history of blood in the stool, fever, chills, or rash.
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Images in Clinical Medicine
Insulin-Induced Lipohypertrophy
Figure 1.
- February 2, 2012
- Landau S.
- N Engl J Med 2012; 366:e9
- Free Full Text
A 55-year-old man with a 31-year history of type 1 diabetes mellitus presented for a routine clinical evaluation, his first in two decades. His insulin regimen consisted of a combination of neutral protamine Hagedorn (NPH) and rapid-acting insulin. In the ...
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Clinical Implications of Basic Research
Closing the Iron Gate
Genetic hemochromatosis is a prevalent iron-overload disease resulting from inadequate production of the iron-regulatory hormone hepcidin. Recently, Preza and colleagues developed an oral, biologically active hepcidin mimic that offers a new experimental approach to treating hemochromatosis and…
- January 26, 2012
- Andrews N.C.
- N Engl J Med 2012; 366:376-377
Ferroportin permits the uptake of dietary iron by cells of the intestinal epithelium into the circulation. Hepcidin targets ferroportin for lysosomal destruction. A recent study shows that an engineered minihepcidin reduces levels of iron in the serum and liver.
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Case Records of the Massachusetts General Hospital
Case 3-2012 — A Newborn Boy with Vomiting, Diarrhea, and Abdominal Distention
Presentation of Case. Dr. Rebecca C. Bell (Pediatrics): A 6-day-old boy was admitted to this hospital because of vomiting, diarrhea, and abdominal distention. The patient was born at another hospital to a teenaged primigravida by vaginal delivery after a full-term, uncomplicated gestation. The…
- January 26, 2012
- Melendez E., Goldstein A.M., Sagar P., Badizadegan K.
- N Engl J Med 2012; 366:361-372
A 6-day-old boy was admitted to the hospital because of vomiting, diarrhea, and abdominal distention, which had begun earlier that day and worsened. On admission, he showed signs of sepsis. Imaging showed narrowing of the rectosigmoid colon.
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Images in Clinical Medicine
Pneumopericardium Associated with a Peptic Ulcer
Figure 1.
- December 22, 2011
- Andrianov A. and Nissenbaum M.A.
- N Engl J Med 2011; 365:2412
- Free Full Text
A 63-year-old man with a history of peptic ulcer and recent use of NSAIDs presented to the emergency department with acute shortness of breath and chest pain. He had hypotension and tachycardia.
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Medical Meetings Pediatrics Conferences and Meetings

2012 Certifying Examinations of the American Board of Pediatrics

The general pediatrics examination will be held in various cities, Oct. 16-18. Registration for first-time applicants is ongoing through May 3. Registration for re-registrants is ongoing through May 24. The following subspecialty examinations will be held in various cities: "Hospice and Palliative Medicine" (Oct. 4); "Pediatric Transplant Hepatology" (Oct. 11); "Pediatric Cardiology" (Nov. 7); "Pediatric Pulmonology" (Nov. 8); "Medical Toxicology" (Nov. 12); and "Pediatric Critical Care Medicine" (Nov. 14). Registration for first-time applicants is ongoing through April 30. Registration for re-registrants is ongoing through June 15.

Contact the American Board of Pediatrics, 111 Silver Cedar Court, Chapel Hill, NC 27514-1513; or call (919) 929-0461; or fax (919) 918-7114 or (919) 929-9255; or see http://www.abp.org .

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Browse Gastroenterology General

Showing 1 to 20 of 1185 Articles

Filter Results

Surgery or Medical Therapy for Obese Patients with Type 2 Diabetes?

Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes

Pneumoperitoneum

Low-Dose Abdominal CT for Evaluating Suspected Appendicitis

Familial Diarrhea Syndrome Caused by an Activating GUCY2C Mutation

Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes

Case 12-2012 — A 10-Month-Old Girl with Vomiting and Episodes of Unresponsiveness

Achalasia

A Randomized Trial of Rectal Indomethacin to Prevent Post-ERCP Pancreatitis

Intestinal Infestation with Ancylostoma ceylanicum

Case 10-2012 — A 16-Year-Old Boy with Epigastric Pain and a Mediastinal Mass

Eruptive Xanthoma

Challenges Facing JAK Inhibitor Therapy for Myeloproliferative Neoplasms

Sigmoid Perforation in Association with Colonoscopy

Mechanisms of Disease: IgG4-Related Disease

Worth a Second Look

Insulin-Induced Lipohypertrophy

Closing the Iron Gate

Case 3-2012 — A Newborn Boy with Vomiting, Diarrhea, and Abdominal Distention

Pneumopericardium Associated with a Peptic Ulcer

Medical Meetings Pediatrics Conferences and Meetings

2012 Certifying Examinations of the American Board of Pediatrics

Trends: Most Viewed (Last Week)