Olalekan Akanbi

• MD, MPH
• Professor (Assistant) at University of Kentucky

Background The Gemini trial failed to detect a significant difference in response rate for patients with ulcerative colitis (UC) randomized to standard (every 8 week) vedolizumab dosing vs escalated (every 4 week) dosing. Subsequent real-world data imply the Gemini trial design may have obscured a benefit of escalated dosing.AimsWe investigated out...

Background and AimsLeaving against medical advice (LAMA) is an unfortunate occurrence in 1–2% of all hospitalized patients and is associated with worse outcomes. While this has been investigated across multiple clinical conditions, studies on patients with chronic pancreatitis (CP) are lacking. We aimed to determine the prevalence and determinants...

Background Patients with chronic pancreatitis (CP) suffer from pain and receive increased opioid prescriptions with a high risk of opioid use disorder (OUD). We studied the predictors, trends and outcomes of OUD among patients hospitalized with CP. Methods Records with CP (with/without OUD) were extracted from the Nationwide Inpatient Sample (NIS)...

Background: Clinicians often utilize off-label dose escalation of ustekinumab (UST) in Crohn's disease (CD) patients with disease refractory to standard dosing. Previous studies report mixed results with dose escalation of UST. Methods: A retrospective observational study of 143 adult patients with CD receiving UST over a 33-month time period wa...

Abstract Background: Clinicians often utilize off-label dose escalation of ustekinumab (UST) in Crohn’s disease (CD) patients with disease refractory to standard dosing. Previous studies report mixed results with dose escalation of UST. Methods: A retrospective observational study of 143 adult patients with CD receiving UST over a 33-month time per...

Background The aim of this study is to evaluate race-associated risk factors of acute pancreatitis (AP) in inflammatory bowel disease (IBD) patients. Methods A retrospective analysis using 2016 and 2017 National Inpatient Sample database was performed. Inclusion criteria were principal diagnosis of AP and a secondary diagnosis of IBD. Patients be...

Introduction Six years ago, the Gemini pharma trial reported no significant difference in response rate between Ulcerative Colitis (UC) patients randomized to q8week vedolizumab dosing vs q4weeks.1 In Gemini, patients were randomized based on response after 6 week induction, but post-hoc analysis and real world data report an average response time...

Background Ustekinumab, a monoclonal antibody of interleukin-12 and interleukin-23, was approved for the treatment of moderate to severe Crohn’s disease (CD) in 2016. Ustekinumab is approved in CD for a weight-based IV induction dose followed by every 8 weeks of subcutaneous dosing. Response rates by 6 weeks range from 34% (anti-TNF failures) to 56...

INTRODUCTION Microscopic colitis (MC) is a chronic inflammatory disease of the colon that is responsible for up to 10-15% of chronic watery diarrhea (Cotter TG, Binder M, Loftus EV, et al. Gut 2018). While this disease is often self-limiting, some patients suffer from severe disease that can be refractory to standard medical therapies, such as Imod...

INTRODUCTION Pancreatic cancer is a highly aggressive cancer. Worldwide, pancreatic cancer is the eighth leading cause of cancer deaths in both men (226,910 deaths annually) and women (205,332 deaths annually). Five-year survival rate even for node negative R0 pancreaticoduodenoectomy is only 30 percent and it is worse in case of node positive canc...

INTRODUCTION Autoimmune hepatitis (AIH) is a chronic inflammatory condition of the liver characterized by elevated hepatocellular enzymes, autoantibodies, immunoglobulins, periportal inflammation and rapid improvement with steroids. Associated peripheral eosinophilia has been rarely reported. We report a case of AIH presenting with eosinophilia. C...

INTRODUCTION Multiple observational studies have reported associations between long-term PPI use and adverse events particularly in the elderly leading to increased morbidity and healthcare utilization. We examined the trend, per-patient expenditures and healthcare resource utilization associated with PPI use in non-institutionalized elderly in the...

Introduction Often regarded as a poor prognostic factor in ascites, spontaneous bacterial peritonitis (SBP) is usually caused by Gram negative rods (E. coli, K. pneumoniae) and Gram positive cocci (S. pneumoniae).This case report identifies 2 rare cases of SBP. CASE DESCRIPTION/METHODS Case 1 A 59 yo M with h/o decompensated cirrhosis (ascites wit...

INTRODUCTION: Inflammatory bowel disease (IBD) patients are chronically prescribed narcotics for chronic relapsing abdominal pain. We previously reported that emergency room (ER) visits in IBD patients increase the risk for chronic opioid use (COU - defined as 90 days of opioid use in a 6-month period) (Pauley et al Infl Bowel Dis 2017). Here we e...

INTRODUCTION 5-Fluorouracil (5-FU), an antimetabolite used in the management of advanced gastrointestinal cancers, is often complicated by the development of colitis with several reported cases. However, there has been no report of new onset ulcerative colitis (UC) following 5-FU-based chemotherapy. We report a case of 5-FU-induced UC in a patient...

INTRODUCTION Opioids are a mainstay of chronic pain management however their continued use has become a public-health crisis with potential for abuse and associated adverse outcomes. Patients with Chronic Pancreatitis (CP) suffer from recurrent debilitating pain and are thus susceptible to opioid abuse. We aimed to determine the prevalence, trends...

Background: The Fecal Occult Blood Test (FOBT) is one of the diagnostic modalities indicated for screening patients for Colorectal Cancer (CRC). Despite being approved only for screening for CRC, numerous studies in the past have illustrated misuse of the FOBT. We examined utilization of the FOBT for patients admitted to a community teaching hospi...

Background and Aims Providing diagnostic and therapeutic interventions, lower gastrointestinal endoscopy is a salient investigative modality for ischemic bowel disease (IB). As studies on the role of endoscopic timing on the outcomes of IB are lacking, we sought to clarify this association. Methods After identifying 18-to-90-year-old patients with...

Background: As the frequency of nonalcoholic fatty liver disease (NAFLD) continues to rise in the United States (US) community, more patients are hospitalized with NAFLD. However, data on the prevalence and outcomes of hospitalizations with NAFLD are lacking. We investigated the prevalence, trends and outcomes of NAFLD hospitalizations in the US. M...

Background: Protein-energy malnutrition (PEM) diminishes amino acid and energy availability, impairing the body's healing capability after injury, such as in myocardial damage following acute myocardial infarction (AMI). Aims: We sought to investigate the influence of PEM on clinical outcomes of AMI. Methods: We identified records with a prima...

Background: Improving survival rates among patients with breast cancer has been associated with an increase in the prevalence of co-morbidities like cancer-related pain. Opioids are an important component in the management of pain among these patients. However, the progression from judicious use to abuse defeats the aim of pain control. Non-steroi...

Background: Protein-energy malnutrition (PEM), resulting from depleted energy and nutrient stores, compromises the body's defense systems and may exacerbate sepsis and its impact. However, population-based studies examining the association of PEM on the prevalence and health-care burden of sepsis are lacking. Objective: To investigate the relati...

Herpes simplex virus-2 (HSV2) hepatitis represents a rare but serious complication of HSV2 infection that can progress to acute liver failure (ALF). We describe a case of a pregnant teenager who presented with four days of fever, headache, malaise, nausea, and vomiting. She was initially misdiagnosed with sepsis of unclear source and treated with b...

OBJECTIVES/SPECIFIC AIMS: Protein Energy Malnutrition (PEM) could compromise the body’s defense systems resulting in sepsis, which further depletes calorie stores. Among hospitalized patients, we investigate 1) the relationship between PEM and sepsis, 2) the impact of PEM on trends in mortality from sepsis, and 3) the influence of PEM on clinical o...

Voriconazole is a triazole antifungal agent commercially approved in 2002. It is commonly used in immunocompromised patients as a therapeutic and prophylactic agent. We present the case of a 26-year-old Caucasian female who is a double lung transplant recipient who presented with complaints of generalized left lower extremity swelling and extreme t...

Myxomas, metastatic tumors, thrombi, and vegetations top the differential diagnosis list of cardiac masses. We present a case of ectopic liver tissue, a far less common etiology of a right atrial mass, discovered incidentally on transthoracic echocardiography (TTE) of a 37-year-old female with multiple comorbidities who was referred to our facility...

Background Alcoholic gastritis, a superficial erosive disease of the stomach, is a common manifestation of risky alcohol use. In contrast, cannabis which is frequently co‐used with alcohol suppresses gastric acidity and might counteract the deleterious effect of alcohol on the gastric mucosa. However, no clinical study has examined the impact of ca...

Chronically elevated cytokines from un-abating low-grade inflammation in heart failure (HF) results in Protein-Energy Malnutrition (PEM). However, the impact of PEM on clinical outcomes of admissions for HF exacerbations has not been evaluated in a national data. From the 2012 to 2014 Nationwide Inpatient Sample (NIS) patient's discharge records fo...

Background Pancreatitis is an increasingly common clinical condition that causes significant morbidity and mortality. Cannabis use causes conflicting effects on pancreatitis development. We conducted a larger and more detailed assessment of the impact of cannabis use on pancreatitis. Methods We analyzed data from 2012 to 2014 of the Healthcare Cos...

Background and aims Clinical conditions resulting in hypoxia, hypoperfusion, anaerobic milieu within the gut, and intestinal epithelial breakdown, such as seen in heart failure, precipitates Clostridium difficile infection (CDI). Given that ischemic bowel disease (IB) typically results in similar changes within the gut, we investigated the relation...

Background: Sickle cell disease (SCD) is the most common inheritable hematologic disorder in the USA and is associated with ischemic organ diseases. SCD-associated ischemic bowel disease is increasing being recognized, and studies on the hospitalization outcomes of such patients are limited. Objective: This study aimed to compare the inpatient o...

Antibiotic-associated colitis is a gastrointestinal complication of antibiotic use commonly seen in hospitalised patients, with Clostridium difficile (C. difficile) colitis being the most common type. We present a case of haemorrhagic colitis secondary to Klebsiella oxytoca following self-initiated amoxicillin–clavulanic acid use. An 85-year-old wo...

Aim: To systematically review the medical literature in order to evaluate the safety and efficacy of gastric endoscopic submucosal dissection (ESD). Methods: We performed a comprehensive literature search of MEDLINE, Ovid, CINAHL, and Cochrane for studies reporting on the clinical efficacy and safety profile of gastric ESD. Results: Twenty-nin...