Evaluation of Arsenic Contamination in Texas

Lowering the federal standard for arsenic in drinking water from 50 µg/L to 10 µg/L has led to a much wider spread of arsenic contamination in groundwater across Texas. This study aimed to (1) determine the distribution of arsenic in Texas groundwater, (2) assess the potential impact of past arsenical pesticide applications on groundwater in the southern High Plains and southwestern Gulf Coast, (3) evaluate the role of phosphate fertilizers in mobilizing arsenic, and (4) assess geologic sources of arsenic in Texas. The focus was on areas with domestic drinking water wells affected by high arsenic levels. The Bureau of Economic Geology (BEG) undertook several tasks to achieve these objectives. Firstly, they reviewed groundwater arsenic concentrations in neighboring states and analyzed existing research on elevated arsenic studies in the US. Secondly, potential anthropogenic sources of arsenic, such as arsenical pesticides, were examined using GIS overlay analyses and soil sampling in the southern High Plains and southwestern Gulf Coast. Thirdly, potential geologic sources of elevated arsenic concentrations in groundwater were evaluated in these regions by studying the relationships between arsenic concentrations and different geologic units. Additionally, the impact of various redox conditions on arsenic distribution was explored. Limited additional groundwater sampling was conducted in Duval County in the Gulf Coast. Arsenic contamination is widespread in neighboring states, particularly in New Mexico, where 16% of wells exceed the MCL (10 µg/L). In Oklahoma, only 5% of wells surpassed the MCL, with contamination primarily found in Permian formations in central Oklahoma. Arsenic contamination in Arkansas affects 8% of wells and is associated with alluvial aquifers in eastern Arkansas. In Louisiana, arsenic contamination is limited. In Texas, groundwater arsenic contamination is widespread, with approximately 6% of wells exceeding the MCL of 10 µg/L. The contamination is particularly concentrated in the southern High Plains (32% of wells exceed the MCL) and the southwestern Gulf Coast (29% of wells exceed the MCL).Bureau of Economic Geolog

Fistulizing Crohn's disease

Crohn's disease (CD), characterized by idiopathic transmural inflammation anywhere along the gastrointestinal (GI) tract, is increasing in incidence worldwide for unknown reasons. The transmural inflammation can result in inflammatory, stricturing, or penetrating (fistulizing) phenotypes, all of which are notoriously difficult to treat. When a patient has inflammatory disease, medical immunosuppressive therapy with corticosteorids, immunomodulators, or biologics may be helpful before a fibrostenotic disease process starts. Once there is fibrosis, bowel damage is difficult to reverse, and proximal fistulizing disease may develop. Fistulizing disease, one of the most notoriously difficult disease manifestations can also occur anywhere along the GI tract, affecting portions as proximal as the duodenum or as distal as the anus with perianal and rectovaginal fistulas (RVFs)

Management of pouch neoplasia: consensus guidelines from the International Ileal Pouch Consortium

Surveillance pouchoscopy is recommended for patients with restorative proctocolectomy with ileal pouch–anal anastomosis in ulcerative colitis or familial adenomatous polyposis, with the surveillance interval depending on the risk of neoplasia. Neoplasia in patients with ileal pouches mainly have a glandular source and less often are of squamous cell origin. Various grades of neoplasia can occur in the prepouch ileum, pouch body, rectal cuff, anal transition zone, anus, or perianal skin. The main treatment modalities are endoscopic polypectomy, endoscopic ablation, endoscopic mucosal resection, endoscopic submucosal dissection, surgical local excision, surgical circumferential resection and re-anastomosis, and pouch excision. The choice of the treatment modality is determined by the grade, location, size, and features of neoplastic lesions, along with patients' risk of neoplasia and comorbidities, and local endoscopic and surgical expertise