Amar R. Deshpande, MD
Associate Professor of Medicine
Division of Gastroenterology, Department of Medicine
University of Miami Miller School of Medicine
Miami, FL

Amar R. Deshpande completed a medical degree at the University of Miami School of Medicine. He then stayed at the University of Miami and Jackson Memorial Hospital for his internal medicine residency and gastroenterology fellowship.

Dr. Deshpande’s principal interest in gastroenterology is the study and care of patients with inflammatory bowel disease. He is also jointly a member of the Department of Medical Education, coordinating GI education for medical students, the fellowship program, and other housestaff at the University of Miami Miller School of Medicine and Jackson Memorial Hospital.

Dr. Deshpande has authored articles, book chapters, and reviews in journals such as Gastroenterology, American Journal of Gastroenterology, and Gastrointestinal Endoscopy and has had multiple presentations at national meetings.

University of Miami

The Division of Gastroenterology is devoted to the quality care of patients, clinical research in disorders of the gastrointestinal tract and liver, and the education of physicians in the diagnosis, management, and treatment of patients with gastrointestinal disorders.

Our mission is to deliver outstanding, educated gastroenterology care to the community of South Florida and Latin America and to make scientific discoveries that will improve gastrointestinal health for all patients.

The Division of Gastroenterology provides excellent patient care, conducts cutting-edge clinical research in disorders of the gastrointestinal tract, and educates physicians in the diagnosis, management, and treatment of patients with gastrointestinal disorders. The division’s nationally and internationally recognized faculty deliver clinical care at the University of Miami Hospital, the Sylvester Cancer Center, Jackson Memorial Hospital and the Miami Veterans Affairs Medical Center. The University of Miami Division of Gastroenterology is also affiliated with Mount Sinai Medical Center. All of these settings provide a unique opportunity for performing clinical research and for training the next generation of gastroenterologists in our gastroenterology fellowship program. Faculty members in the division also have a wide range of special research interests, including inflammatory bowel disease, gastrointestinal cancer, disorders of the pancreas, as well as diagnostic and therapeutic gastrointestinal endoscopy. The division conducts research in the immunology of the gastrointestinal tract and in ulcer disease, pancreatic diseases, and diverticulitis.

 Systematic review with network meta-analysis: the efficacy of anti-tumour necrosis factor-alpha agents for the treatment of ulcerative colitis.

 The incidence and risk factors for developing depression after being diagnosed with inflammatory bowel disease: a cohort study.

 Challenges and possible solutions to colorectal cancer screening for the underserved.

 Therapeutic drug monitoring in patients with inflammatory bowel disease.

 Systematic review with network meta-analysis: the efficacy of anti-TNF agents for the treatment of Crohn's disease.

 TITLE
Real-time Diagnosis of PseudopolypsDuring Colonoscopy Using Noninvasive Advanced Endoscopic Techniques - a Prospective Study


PURPOSE
Significance: Biopsy of potentially benign pseudopolyps and the surrounding mucosa adds expense and prolongs the time of endoscopic procedures. Use of endoscopic technologies could decrease the need and expense of endoscopic biopsy for these lesions.

Hypothesis: Pseudopolyps will have a distinctive pattern with the specialized imaging techniques of high definition imaging, narrow band imaging, and endoscopic dye-spraying techniques using indigo carmine which will predict diagnosis without biopsy.

100 patients with inflammatory bowel disease will be enrolled in the study. Following a standard bowel preparation, each patient will be evaluated using standard endoscopic equipment. All patients will receive a standard bowel preparation (sodium phosphate, PEG-3350, or magnesium citrate based preparations). All colonoscopic evaluations will be performed for indications unrelated to the present study, including evaluation of response to medical treatment, routine surveillance exams for dysplasia, diarrhea, or rectal bleeding. Polypoid lesions will be examined using four consecutive methods: (a) high definition white light, (b) narrow band imaging, (c) chromoendoscopy (high definition white light with indigo carmine dye-spraying), and (d) histologic examination following biopsy. The flat mucosa surrounding the polypoid lesions will also be examined using theses four techniques in an effort to identify dysplastic tissue associated with these polypoid growths.

High definition white light is the standard imaging modality used for colonoscopy. Narrow band imaging (blue wavelength of light) is also used routinely and is available on all current generation colonoscopes with the press of a button. Our division routinely uses chromoendoscopy as part of surveillance for dysplasia in patients with inflammatory bowel disease. Dye spraying catheters or flushing will be utilized for dye application to mucosa. The dye used will be indigo carmine.

Directed biopsy specimens will then be performed using a multibite forceps for targeted biopsies. Routine biopsies will be performed as clinically indicated. Pathology slides will be reviewed by the gastrointestinal pathologists at the University of Miami. The gastroenterologist's interpretation based on each of the three successive endoscopic methods will then be compared to the histologic evaluation with each individual lesion serving as its own control.


ELIGIBILITY
Ages Eligible for Study: 18 Years to 75 Years
Genders Eligible for Study: Both
Accepts Healthy Volunteers: No
Sampling Method: Non-Probability Sample


STUDY POPULATION
Approximately 100 patients with inflammatory bowel disease (IBD) will be enrolled in the study. They will be identified from a population of patients undergoing colonoscopy for diagnostic purposes with IBD.


CRITERIA
Inclusion Criteria:
• Patients equal to or over 18 years of age with a confirmed diagnosis of inflammatory bowel disease with plans for routine colonoscopic evaluation and able to provide informed consent will be included.

Exclusion Criteria:
• Patients under 18 years of age.
• Patient unwilling or unable to undergo colonoscopy with biopsies or preparation for colonoscopy.

 Other IBD-Relevant Ongoing Research/Active Protocols:

1) Predictors of Complicated Clinical Course in Patients with Inflammatory Bowel Disease

2) The Epidemiology of IBD in Hispanics and Afro-Caribbean Patients

3) Inflammatory Bowel Disease (IBD) Center Clinical Phenotype Database and Tissue Repository

4) A Phase 3, Randomized, Placebo-Controlled, Blinded, Multicenter Study of the Induction and Maintenance of Clinical Response and Remission by Vedolizumab (MLN0002) in Patients with Moderate to Severe Ulcerative Colitis

5) A Phase 3, Randomized, Placebo-Controlled, Blinded, Multicenter Study of the Induction and Maintenance of Clinical Response and Remission by Vedolizumab (MLN0002) in Patients with Moderate to Severe Crohn’s Disease

6) A double-blind, randomized, placebo-controlled, dose-ranging study to evaluate the efficacy and safety of PF-00547659 in subjects with Crohn’s disease who are anti-TNF inadequate responders (OPERA)

7) Post-marketing studies: Cimzia (SECURE), Tyasbri (INFORM)