Gastroenterology Commons^™

Seeing The Big Picture: System Architecture Trends In Endoscopy And Led-Based Hyperspectral Subsystem Intergration, Craig M. Browning

<strong> Theses and Dissertations </strong>

Early-stage colorectal lesions remain difficult to detect. Early development of neoplasia tends to be small (less than 10 mm) and flat and difficult to distinguish from surrounding mucosa. Additionally, optical diagnosis of neoplasia as benign or malignant is problematic. Low rates of detection of these lesions allow for continued growth in the colorectum and increased risk of cancer formation. Therefore, it is crucial to detect neoplasia and other non-neoplastic lesions to determine risk and guide future treatment. Technology for detection needs to enhance contrast of subtle tissue differences in the colorectum and track multiple biomarkers simultaneously. This work implements one …

The Role Of The Hypoxia-Inducible Factor 2 In Pancreatic Cancer: Mechanisms Of Tumor Immunosuppression And Intestinal Radioprotection, Carolina Garcia Garcia

Dissertations & Theses (Open Access)

Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with dismal prognosis. The only curative option for patients is surgery, but over 80% of patients are not surgical candidates. Unfortunately, PDAC is resistant to the three remaining options. PDAC is characterized by a profoundly hypoxic and immunosuppressive stroma, which contributes to its therapeutic recalcitrance. Alpha-smooth muscle actin+ (αSMA+) cancer-associated fibroblasts (CAFs) are the most abundant stromal component, as well as mediators of stromal deposition. The hypoxia-inducible factors (HIF1 and HIF2) coordinate responses to hypoxia, yet, despite their known association to poor patient outcomes, their functions within the PDAC tumor microenvironment (TME) …

Progressive Endoscopic Approach To Balloon Dilation For Benign Esophageal Strictures, Chad J. Cooper

Theses and Dissertations--Clinical and Translational Science

Benign esophageal strictures are a frequently encountered problem in clinical practice. The management of benign esophageal strictures have slowly evolved over the decades based on “expert opinion.” Despite vast amounts of data about the efficacy and safety of dilation, unfortunately there is no consensus on a systematic and safe approach that is efficient, limits complications and provides long lasting improvement of dysphagia. Our group designed a progressive approach to endoscopic balloon dilation based on tailoring certain technical aspects of the dilation process.

Most studies in the literature concluded that endoscopic dilation is safe and effective in relieving dysphagia caused by …

What Are The Rhetorical Strategies And Consequences Of Food Labels Regarding Health, Lifestyle, And Ethics Of Consumers With Food-Related Diseases And Allergies?, Delaney Borchers

Master of Arts in Media and Communication Plan II Graduate Projects

In this study, it is investigated on how health, lifestyle and ethical factors of a consumer with a gluten-related disease and allergy influence their understanding and awareness of gluten-free food labels. This study was implemented through an online survey on a Facebook support group with a total of 195 respondents. The results show that consumers do have a strong awareness and understanding of the differences between certified gluten-free and non-certified gluten-free food labels. This indicates that having this strong awareness and understanding is influenced based upon a consumer’s health, lifestyle and ethical factors of following a gluten-free diet.

Elucidating The Complex Signaling Events Driving Intestinal Stem Cell Plasticity Following Injury, Evan Lynch

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

Signaling events governing intestinal stem cell (ISC) homeostasis maintain the delicate balance of active self-renewal and passive differentiation to replenish intestinal epithelial cells (IEC) every 3-5 days. However, under certain contexts, ISC function is irreversibly compromised—requiring committed IEC lineages to dedifferentiate and regain “stemness”. In the current studies, we examine the signaling events driving epithelial cell responses to injury to expose pathologic failures in the healing response. Our specific goal is to tease out the cellular contexts that promote dedifferentiation to design effective therapeutics for disease conditions compromising ISC function.

First, we generated a novel transgenic animal using the epithelial-specific …

Drug Response And Metabolism In Crohn's Disease, Aze Wilson

Electronic Thesis and Dissertation Repository

Inflammatory bowel disease (IBD) is an illness of chronic intestinal inflammation comprised of Crohn's disease (CD) and ulcerative colitis (UC). Specialists rely heavily on drugs that target a dysregulated immune system. There is a staggering degree of variation in drug response in CD. Our understanding of drug metabolism and response in IBD is limited. Gaining new insights into IBD-specific modifications of drug metabolism may allow for improved drug efficacy and reduced toxicity. Cytochrome P450 (CYP) 3A4 is the most relevant determinant of drug metabolism and exposure for medications prescribed today. CYP3A4 is highly expressed in the liver, but is also …

Understanding The Role Of Phosphoinositide 3-Kinase And Its Function As A Driving Force Behind The Er Stress Response In Fibrostenotic Crohn’S Disease-Affected Ileal Smooth Muscle Cells, Prashant Yadav

Theses and Dissertations

Crohn’s disease (CD) affects about 780,000 people in the United States alone, and it is estimated that 6-15 per 100,000 persons will receive a diagnosis of this disease each year. There currently is no cure for Crohn’s disease, and available medical therapies simply serve to alleviate the inflammation. This does not help treat fibrostenosis that Crohn’s disease patients may develop, which can only be treated surgically. Finding alternatives to treat CD requires an understanding of mechanisms at the biochemical level. In this thesis, we attempted to gain a better understanding of certain pathways found to be active in Crohn’s disease-affected …

Risk Of Post-Ercp Pancreatitis In Liver Transplant Patients: Single Center Experience, Shailender Singh

Theses & Dissertations

Introduction: Acute pancreatitis remains the most common severe complication of endoscopic retrograde cholangiopancreatography (ERCP). The exact cause of post-ERCP pancreatitis (PEP) is unclear. Regardless of the mechanism that initiates PEP, the pathways of inflammation are similar to other forms of acute pancreatitis and include the activation of various inflammatory cytokines, released from the acinar cells and subsequently from helper T lymphocytes and macrophages. Liver transplants (LTx) patients on immunosuppressive medications have impaired T-cell response and hence decreased ability to generate these cytokines. The aim of this study was to review incidence rates and risk factors of PEP in this …

Development Of Clinical Prediction Models For Surgery And Complications In Crohn’S Disease, Leonard M. Guizzetti

Electronic Thesis and Dissertation Repository

Background and Objective: Crohn’s disease (CD)-related complications account for a substantial proportion of IBD-related healthcare expenditure. Identifying patients at risk for complications may allow for targeted use of early therapeutic interventions to alter this natural course. The objective of this project was to develop risk prediction models of CD-related surgery and complications.

Methods: Using data from the REACT cluster-randomized clinical trial (N=1898 from 41 community practices), prediction models were developed and internally validated for CD-related surgery and CD-related complications, defined as the first CD-related surgery, hospitalization or complication within 24 months. Performance of each model was assessed in terms of …

In Adults With Acute Diarrhea, Which Treatment Is More Effective Between Loperamide And Racecadotril?, Lorena A. Castillo

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine which treatment is more effective between loperamide and racecadotril to treat acute diarrhea in adults.

STUDY DESIGN: Review of three English language primary randomized controlled studies published from 1999-2005.

DATA SOURCES: First study was a RCT that was double blinded, double placebo, parallel study group and second and third study was RCT single blinded, comparative parallel group that all compared efficacy of loperamide and racecadotril. These were all found by using PubMed, COCHRANE and NCBI.

OUTCOMES MEASURED: Each of the studies measured the efficacy of each …

Are Sodium Alginate Solutions Effective In Reducing Postprandial Symptoms In Adults With Gastroesophageal Reflux?, Kristi L. Hackman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not sodium alginate solutions are effective in reducing postprandial symptoms in adults with gastroesophageal reflux?

STUDY DESIGN: A review of three English language studies published from 2006-2011. Includes two randomized, double-blind, controlled trials and one controlled case series.

DATA SOURCES: Randomized, placebo-controlled studies evaluating the effectiveness and safety of sodium alginate solutions (Gaviscon) for managing gastroesophageal reflux disease (GERD) symptoms in adults were located using the PubMed, CINAHL, and Cochrane Library databases.

OUTCOMES MEASURED: The primary measures of effectiveness used were the Reflux Severity Index Questionnaire …

Clinical Use Of Probiotics: A Survey Of Physicians’ Beliefs And Practice Patterns, Anastasia Ensminger

Master's Theses and Doctoral Dissertations

Background: Probiotics have the potential to be used as a preventive agent or adjuvant therapy for various medical conditions, and recent research is beginning to illuminate some of the associated benefits. Some clinicians currently prescribe probiotics in practice. Understanding physicians’ beliefs and practice patterns regarding the use of probiotics will help identify current practices, barriers preventing their acceptance, and the sources of information that impact clinical practice.

Objective: To identify and describe physicians’ beliefs and practice patterns regarding the use of probiotics.

Methods: A cross-sectional online questionnaire was administered to 130 physicians employed by or affiliated with Danville …