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Browsing by Author "Ehrlich, Adam C."
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Item Fecal Microbiota Transplantation Is Highly Effective in Real-World Practice: Initial Results From the FMT National Registry(Elsevier, 2021-01) Kelly, Colleen R.; Yen, Eugene F.; Grinspan, Ari M.; Kahn, Stacy A.; Atreja, Ashish; Lewis, James D.; Moore, Thomas A.; Rubin, David T.; Kim, Alison M.; Serra, Sonya; Nersesova, Yanina; Fredell, Lydia; Hunsicker, Dea; McDonald, Daniel; Knight, Rob; Allegretti, Jessica R.; Pekow, Joel; Absah, Imad; Hsu, Ronald; Vincent, Jennifer; Khanna, Sahil; Tangen, Lyn; Crawford, Carl V.; Mattar, Mark C.; Chen, Lea Ann; Fischer, Monika; Arsenescu, Razvan I.; Feuerstadt, Paul; Goldstein, Jonathan; Kerman, David; Ehrlich, Adam C.; Wu, Gary D.; Laine, Loren; Medicine, School of MedicineBackground & Aims Fecal microbiota transplantation (FMT) is used commonly for treatment of Clostridioides difficile infections (CDIs), although prospective safety data are limited and real-world FMT practice and outcomes are not well described. The FMT National Registry was designed to assess FMT methods and both safety and effectiveness outcomes from North American FMT providers. Methods Patients undergoing FMT in clinical practices across North America were eligible. Participating investigators enter de-identified data into an online platform, including FMT protocol, baseline patient characteristics, CDI cure and recurrence, and short and long-term safety outcomes. Results Of the first 259 participants enrolled at 20 sites, 222 had completed short-term follow-up at 1 month and 123 had follow-up to 6 months; 171 (66%) were female. All FMTs were done for CDI and 249 (96%) used an unknown donor (eg, stool bank). One-month cure occurred in 200 patients (90%); of these, 197 (98%) received only 1 FMT. Among 112 patients with initial cure who were followed to 6 months, 4 (4%) had CDI recurrence. Severe symptoms reported within 1-month of FMT included diarrhea (n = 5 [2%]) and abdominal pain (n = 4 [2%]); 3 patients (1%) had hospitalizations possibly related to FMT. At 6 months, new diagnoses of irritable bowel syndrome were made in 2 patients (1%) and inflammatory bowel disease in 2 patients (1%). Conclusions This prospective real-world study demonstrated high effectiveness of FMT for CDI with a good safety profile. Assessment of new conditions at long-term follow-up is planned as this registry grows and will be important for determining the full safety profile of FMT.Item Virtual Gastroenterology Fellowship Recruitment During COVID-19 and Its Implications for the Future(Springer, 2021) Hamade, Nour; Bhavsar-Burke, Indira; Jansson-Knodell, Claire; Wani, Sachin; Patel, Swati G.; Ehrlich, Adam C.; Paine, Elizabeth; Hosseini‑Carroll, Pegah; Menard-Katcher, Paul; Fayad, Nabil; Medicine, School of MedicineBackground and Aims Amid the COVID-19 pandemic, medical education organizations endorsed a virtual recruitment format, representing a stark change from traditional in-person interviews. We aimed to identify the attitudes and perceptions of Gastroenterology Fellowship Program Directors (PDs) and applicants regarding the virtual interview experience and the role of virtual interviews (VI) in the future. Methods We designed separate surveys targeting PDs and applicants using the Qualtrics software. At the end of the interview season, we e-mailed both survey links to all PDs and requested that they forward the applicant survey to their interviewed candidates. Surveys were voluntary and anonymous. Descriptive statistics were used to analyze the data with results presented as percentages. Results A total of 29.7% of PDs completed the survey. Compared to traditional interviews, VI were viewed by 46.5% of PDs to be very suboptimal or suboptimal. Yet, 69.1% envisioned a role for VI in the future. A total of 14.2% of applicants completed the survey. Compared to traditional interviews, VI were viewed by 42.3% of applicants to be very suboptimal or suboptimal. However, 61.8% saw a future role for VI. While both applicants and PDs reported that establishing an interpersonal connection was a disadvantage with VI, applicants placed more emphasis on this need for connection (p = 0.001). Conclusion Overall, PDs and applicants report mixed views with regard to VI but anticipate that it may continue to have a future role. VI may augment future recruitment cycles with care taken to not disadvantage applicants, who rely heavily on the interview process to create personal connections with programs.