Addressing gender in GI, important catalysts for change: open communication b/w attendings & fellows about comfort w/ physical contact when teaching endoscopy, equal representation of M/F endosocpists in industry and new device marketing #WIM#WomenInGIsciencedirect.com/science/articl…
More visible presence of women in conference leadership- research shows female conference attendees are better engaged and more encouraged to ask questions when speaker or panelist is a woman
Recognizing signs of sexual harassment and unprofessional behavior and taking steps to stop them including inappropriate jokes and innuendoes. Nearly half of US trainees in procedural field report experiencing harassement during training.
Finally, making conscious efforts to become an inclusive and diverse field with more women acting as role models and offering mentorship to both female and male trainees interested in pursuing this field
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@MondayNightIBD@DCharabaty 1/ Thiopurines are associated with an increased risk of NMSC (non-melanoma skin cancer)
Which of the following is true about this risk relative to non-exposed IBD pts, duration of thiopurine use , and after thiopurine cessation 🛑#Back2Basics#MondayNightIBD
@MondayNightIBD@DCharabaty 32 y/o M with UC here for f/u. In remission x7 yrs on AZA 75mg/d. He is here to discuss his concerns about his risk of lymphoma associated w/ AZA. (HSTCL= hepatosplenic T cell; EBV-L= EBV assoc lymphoma) Which statement is true? #Back2Basics#MondayNightIBD
@MondayNightIBD@SobiaMujtabaMD@JasonHouMD@DCharabaty 1/ 65 y/o M new dx #Crohns ileitis after he presented w abdo pain,diarrhea, wt loss, anemia. CLN: deep linear ulcers in TI. He has an active lifestyle,stable CAD. Symptoms recur when prednisone<15 mg. What is the LEAST effective strategy to keep this pt in remission? #Back2Basics
@MondayNightIBD@ibdnaik@SobiaMujtabaMD@ibdleuven@DCharabaty 2/ Let’s talk #Crohn’s intestinal complications
CD can present w stricturing/perforating complications
50-60% CD will develop strictures, fistulas or abscesses over time
70% require surgical✂️by 15yrs of dx
Surgery not curative, most pts will have endo recurrence 1 yr post-IC✂️
@MondayNightIBD@SobiaMujtabaMD@NabilQuraishi@CholestasisDoc@DCharabaty 1/ 35 y/o M presents with fatigue & generalized pruritus x 6weeks. No skin rash, No abdo pain, diarrhea or 🩸 in stool. AST 62 ALT 64 ALP 435 Tbili 1.3. MRI/MRCP: multifocal strictures & areas of dilatation of intra +extra hepatic ducts. What’s the next step?💡 #Back2Basics#B2B
@MondayNightIBD@SobiaMujtabaMD@FezaRemziMD@DCharabaty 1/ 35 yo F panUC on IFX 10mg q4wk, admitted with abdo pain, hematochezia, malaise. T 39 BP 95/63 HR 110 FCP 900 mcg/g. Abdo distended, TTP; CT: colonic wall thickening+edematous mucosa. Cdiff neg; WBC 15, Hb 6. No improvement despite IVCS+Abx. Which surgery is indicated #B2BPoll
@MondayNightIBD@SobiaMujtabaMD@SchwartzbergMD@DCharabaty 1/ 27 yo F, crohns colitis on AZA, presents w 2wk perianal pain. One week ago a “boil” developed adjacent to the anus, painful to touch and draining cloudy fluid. PE: Perianal fistulous opening tender & draining pus on palpation. What is the next best step ? #B2B
@MondayNightIBD@SobiaMujtabaMD@SchwartzbergMD@DCharabaty 2/Recap #Crohns:
📌Transmural inflammation involving any part of GIT
📌B for Phenotypes: inflammatory/stricturing/penetrating
📌L for location: UGI,SB,Colon
📌Penetrating Behaviors:
Fistulae
Perforations
Intra-abdominal abscesses(IAA)