Saleh, Hasan

ABSTRACT Following a routine screening colonoscopy, a 54-year-old man underwent colon resection for adenocarcinoma, which revealed neoplastic B-cells in the lymph nodes surrounding the colon suggestive of chronic lymphocytic leukemia (CLL). Further evaluation identified a monoclonal B-cell population, and he was diagnosed with monoclonal B-cell lymphocytosis without meeting CLL diagnostic criteria. The patient had no clinical signs of leukemia and did not need acute treatment but was placed under annual surveillance. This case highlights the incidental discovery of neoplastic B-cells, emphasizing the importance of comprehensive histopathological evaluation and clinical correlation to guide management and monitoring for potential progression to CLL.

INTRODUCTION: Electronic health records (EHRs) are a growing source of burden for clinicians treating inflammatory bowel disease (IBD). METHODS: We conducted an EHR survey study targeting IBD clinicians at leading IBD programs throughout the United States. RESULTS: Surveys were sent to 65 IBD clinicians, with 46 responses (70.8%) collected, 41 (89%) were physicians. All clinicians (100%) believe there are opportunities for EHR improvement. Nineteen clinicians (41.3%) felt that their EHR does not enhance IBD patient care. DISCUSSION: This is the first IBD program survey in the United States showing significant dissatisfaction and opportunity for EHR enhancements to improve patient care.

ABSTRACT Severe acute pancreatitis can cause systemic inflammation and multiorgan failure. We present the case of a 60-year-old woman who presented with necrotizing pancreatitis and subsequently developed a sigmoid colon perforation. The perforation presumably occurred because of extravasation of pancreatic enzymes into the abdominal cavity, resulting in colonic wall injury. Our case highlights the rare colonic complications of severe acute pancreatitis.

ABSTRACT Mpox is a rare infection caused by the zoonotic orthopoxvirus. We present the case of a 44-year-old man with HIV and a history of kidney transplant who presented with mpox and developed proctitis-associated bowel obstruction, urinary retention, and eosinophilia. Our case highlights potential gastrointestinal manifestations of severe mpox infection.

Purpose of review Iron overload disorders such as hemochromatosis involve unregulated absorption of dietary iron, leading to excessive iron accumulation in multiple organs. Phlebotomy is the standard of care for removal of excess iron, but dietary modification is not standardized in practice. The purpose of this article is to help standardize hemochromatosis diet counseling based on commonly asked patient questions. Recent findings The clinical benefit regarding dietary modification in iron overload patients is limited due to lack of large clinical trials, but preliminary results are promising. Recent studies suggest diet modification could reduce iron burden in hemochromatosis patients resulting in less annual phlebotomy as supported through small patient studies, concepts of physiology, and animal studies. Summary This article is a guide for physicians to counsel hemochromatosis patients based on commonly asked questions such as foods to avoid, foods to consume, use of alcohol, and use of supplements. The goal of this guide is to help standardize hemochromatosis diet counseling to reduce phlebotomy amount in patients. Standardization of diet counseling could help facilitate future patient studies to analyze the clinical significance.