SpyGlass cholangioscopy for management of choledocholithiasis during pregnancy

To the Editor: We read with great interest the article by Chong and Jalihal [1] regarding endoscopic management of biliary disorders during pregnancy which reaffirms that endoscopic retrograde cholangiopancreatography(ERCP)is safe and effective in managing choledocholithiasis during pregnancy. The authors use ERCP under fluoroscopic guidance with lead apron shielding as well as non-fluoroscopic cannulation using bile flow and bile aspiration as indicators of successful     

Frequency of alcohol and smoking cessation counseling in hepatitis C patients among internists and gastroenterologists

Given the overwhelming evidence that both alcohol consumption and smoking accelerate the progression of hepatitis C virus (HCV)-induced liver disease,we evaluated the frequency of alcohol and smoking counseling of patients with HCV-induced liver disease by their primary care internists and gastroenterologists.One hundred and twenty-three medical records of consecutive patients with HCV-induced liver disease referred by an internist to a gastroenterologist for its management were reviewed. Patient gender, race, history of and counseling against alcohol and tobacco use by a physician and a gastroenterologist were obtained.A database was created using Microsoft Excel. There were 105 African-Americans, 12 Caucasians and six patients of other races/ethnicities. Forty-six (37%) patients were daily tobacco users and 34 (28%) patients were daily alcohol consumers. There was a statistically significant difference in the frequencies of alcohol ( P = 0.0002) and smoking cessation ( P = 0.0022) between gastroenterologists and internists. This study reveals that internists and gastroenterologists, alike, inadequately counsel patients with hepatitis C about tobacco and alcohol use.     

A simple and inexpensive method for plasma transferrin determination

A simple, inexpensive technique for the determination of plasma transferrin levels is presented. Chemicals required for the method are readily available from commercial sources and have a relatively long shelf-life. A simple visible spectrophotometer is the only equipment required. The technique is simple and rapid to perform and is reproducible. Intra-assay coefficient of variation was determined to be 4%; interassay coefficient of variation was determined to be 5%. Reference values were determined on 406 subjects.     

Hereditary angioedema: an unusual case in an African-American woman.

Hereditary angioedema is a rare disorder characterized by a localized subepithelial edema and swelling of the gastrointestinal and upper respiratory tract. The disorder is estimated to occur in 1 in 50,000 to 150,000 individuals. However, the prevalence of the disorder among the African-American population is uncertain. This is a case report of hereditary angioedema occurring in an African-American woman whose symptoms persisted for more than a decade prior to diagnosis.