Digestive System Diseases Commons^™

Radical Social Ecology As Deep Pragmatism: A Call To The Abolition Of Systemic Dissonance And The Minimization Of Entropic Chaos, Arielle Brender

Student Theses 2015-Present

This paper aims to shed light on the dissonance caused by the superimposition of Dominant Human Systems on Natural Systems. I highlight the synthetic nature of Dominant Human Systems as egoic and linguistic phenomenon manufactured by a mere portion of the human population, which renders them inherently oppressive unto peoples and landscapes whose wisdom were barred from the design process. In pursuing a radical pragmatic approach to mending the simultaneous oppression and destruction of the human being and the earth, I highlight the necessity of minimizing entropic chaos caused by excess energy expenditure, an essential feature of systems that aim ...

A Case Of Synchronous Colorectal Carcinoma Manifested As Three Separate Colon Masses, Alyssa Imperatore Do, Linda Szczurek Do, Facos, Alan Shienbaum Do

Stratford Campus Research Day

Colorectal cancer is the second leading cause of cancer-related deaths in the United States amongst cancers that affect both genders. Synchronous colorectal cancer is greater than one primary lesion detected on initial presentation and occurs about 5% of the time.

This is a 78 year-old female with past medical history of left-sided breast cancer treated with neoadjuvant chemotherapy who presented with symptomatic anemia found to have a hemoglobin of five and positive fecal occult blood test. Patient was transfused and taken for EGD/colonoscopy, which showed three polypoid rectal lesions and three separate colon masses. Preliminary pathology showed high grade ...

Gist- An Unusual Case Of Gi Bleeding, Lucy Joo Do, Justin Derosa Do, Drew Chiesa Do, Darshan Roy Md

Stratford Campus Research Day

This is a unique case of a female who was diagnosed and treated with a GIST (gastrointestinal stromal cell tumor) of the stomach.The purpose is to deliver awareness and education to clinicians of this rare malignancy by emphasizing its presentation and characteristics.

A Case Of Signet Ring Cell Colon Carcinoma Initially Presenting As Acute Diverticulitis, Justin Derosa Do, Jonathan Foster Do, Drew Chiesa Do, Darshan Roy Md

Stratford Campus Research Day

This is a unique case of a female with an acute bout of diverticulitis who six weeks later on follow up colonoscopy, was found to have signet ring cell colon carcinoma. The purpose is to deliver awareness of this rare type of colon malignancy, emphasize the continued need for screening colonoscopy, and to provide the reader with a distinct and thought provoking spin on the conventional diagnosis of diverticulitis.

Myeloid Sarcoma: A Rare Cause Of Small Bowel Obstruction, Jonathan Sedeyn Do, Phd, Karlbuto Alexandre, Alan J. Sheinbaum Do, Adeshola Fakulujo Md, Facs

Stratford Campus Research Day

Myeloid sarcoma is a rare and aggressive tumor of myelogenous origin that uncommonly presents in the small bowel. Here we describe the case of a 29 year old male with a two week history of worsening abdominal pain associated with nausea and bilious vomiting. The patient displayed tenderness in the epigastric and periumbilical region with grossly normal lab values. On CT he was found to have a small bowel obstruction with a transition point in the pelvis. Exploration revealed a small bowel mass located approximately 12 cm from the ileocecal valve. Pathological analysis showed large malignant cells with a high ...

Precision Medicine For Crc Patients In The Veteran Population: State-Of-The-Art, Challenges And Research Directions., Shyam S Mohapatra, Surinder K Batra, Srinivas Bharadwaj, Michael Bouvet, Bard Cosman, Ajay Goel, Wilma Jogunoori, Michael J Kelley, Lopa Mishra, Bibhuti Mishra, Subhra Mohapatra, Bhaumik Patel, Joseph R Pisegna, Jean-Pierre Raufman, Shuyun Rao, Hemant Roy, Maren Scheuner, Satish Singh, Gitanjali Vidyarthi, Jon White

Surgery Faculty Publications

Colorectal cancer (CRC) accounts for ~9% of all cancers in the Veteran population, a fact which has focused a great deal of the attention of the VA's research and development efforts. A field-based meeting of CRC experts was convened to discuss both challenges and opportunities in precision medicine for CRC. This group, designated as the VA Colorectal Cancer Cell-genomics Consortium (VA4C), discussed advances in CRC biology, biomarkers, and imaging for early detection and prevention. There was also a discussion of precision treatment involving fluorescence-guided surgery, targeted chemotherapies and immunotherapies, and personalized cancer treatment approaches. The overarching goal was to ...

Approach To The Diagnostic Workup And Management Of Small Bowel Lesions At A Tertiary Care Center (Poster), David Stein, Jonathan Green, Christopher R. Schlieve, Ann K. Friedrich, Kevin P. Baratta, David H. Ma, May Min, Krunal Patel, David R. Cave, Demetrius E. M. Litwin, Mitchell A. Cahan

Senior Scholars Program

Background: Primary small bowel lesions (SBLs) are rare entities that are difficult to characterize with modern endoscopic and radiographic techniques. This makes their diagnosis and management a significant challenge. Further, SBLs vary widely in pathology and gastrointestinal tract location. Therefore, it is important to review prior SBL cases to understand what factors were most beneficial in directing diagnostic approaches and subsequent treatments for these patients.

Purpose: To evaluate diagnostic modalities used and management practices of patients with SBLs at an advanced endoscopic referral center.

Methods: We analyzed patients undergoing surgical management for SBL from 2005-2015 at a single tertiary care ...

Recurrent Episodes Of Acute Pancreatitis Present To The Ed With More Severe Disease By Ct Than First-Time Acute Pancreatitis, Maryam Boumezrag, Hamza Ijaz, Lorna Richards, Sormeh Harounzadeh, Angeline Johny, Paige Kulie, Caitlin Davis, Yan Ma, Maxine Le Saux, Andrew C. Meltzer

GW Research Days 2016 - Present

Study Objective: Approximately 30% of patients with one episode of acute pancreatitis experience a recurrent episode. The objective of this study is to compare the severity of the first-time episode versus recurrent episodes of acute pancreatitis based on CT scan.

Methods: This study was conducted as part of a retrospective chart review at a single academic urban emergency department from 2012-2016. Criteria for inclusion included clinical symptoms of pancreatitis, age greater than or equal to 18 years, ED diagnosis of acute pancreatitis, and, an abdominal CT scan within 24 hours of triage. Exclusion criteria were traumatic cause of acute pancreatitis ...

Clinical-Evolutional Particularities Of The Cryoglobulinemic Vasculitis In The Case Of A Patient Diagnosed With Hepatitis C Virus In The Predialitic Phase, Daniel C. Caragea, Larisa Săndulescu, Vlad Pădureanu, Mircea C. Forțofoiu, Costin Streba, Lidia Boldeanu, Mihail V. Boldeanu, Mircea Popescu-Drigă, Marius E. Ciurea, Maria Forțofoiu, Ion Rogoveanu, Tudorel Ciurea, Cristin C. Vere

Journal of Mind and Medical Sciences

Hepatitis C virus (HCV) represents a fundamental issue for public health, with long term evolution and the gradual appearance of several complications and associated pathologies. One of these pathologies is represented by cryoglobulinemic vasculitis, a disorder characterized by the appearance in the patient’s serum of the cryoglobulins, which typically precipitate at temperatures below normal body temperature (37°C) and dissolve again if the serum is heated. Here, we describe the case of a patient diagnosed with HCV that, during the evolution of the hepatic disease, developed a form of cryoglobulinemic vasculitis. The connection between the vasculitis and the hepatic ...

Serum Anti-Flagellin And Anti-Lipopolysaccharide Immunoglobulins As Predictors Of Linear Growth Faltering In Pakistani Infants At Risk For Environmental Enteric Dysfunction, Sana Syed, Najeeha T. Iqbal, Kamran Sadiq, Jennie Z. Ma, Tauseef Akhund, Wenjun Xin, Sean R. Moore, Enju Liu, Shahida Qureshi, Kerri B. Gosselin, Andrew Gewirtz, Christopher P. Duggan, S Asad. Ali

Pediatric Publications and Presentations

BACKGROUND: Environmental Enteric Dysfunction (EED) in children from low-income countries has been linked to linear growth declines. There is a critical need to identify sensitive and early EED biomarkers.

OBJECTIVE: Determine whether levels of antibodies against bacterial components flagellin (flic) and lipopolysaccharide (LPS) predict poor growth.

DESIGN/METHODS: In a prospective birth cohort of 380 children in rural Pakistan blood and stool samples were obtained at ages 6 and 9 months. Linear mixed effects models were used to examine longitudinal associations between quartiles of anti-flic and anti-LPS antibodies and changes in LAZ, WAZ and WLZ scores. Spearman's correlations were ...

Studies Of Amino Acid Mutations In Drug Resistance Of The Smo Protein, Eunice Wintona

Student Research and Creative Activity Fair

Smoothened receptor (SMO) is a protein that in humans, is encoded by the SMO gene. A systemic mutation in its binding pocket helps predict the sensitivity of mutant proteins to different drugs. Known as a GPCR-like receptor, it is a component of the hedgehog signaling pathway; a pathway involved in body patterning and the regulation of adult stem cells. An uncontrolled or inappropriate activation of the Hedgehog pathway drives tumor progression in cancers and a number of birth defects. To achieve these goals, the molecular modeling software MOE was used to build small molecules and drug molecules like Vismodegib and ...

The Conundrum Of Indeterminate Quantiferon-Tb Gold Results Before Anti-Tumor Necrosis Factor Initiation, Shahrad Hakimian, Yevgeniy Popov, Abbas Rupawala, Karen I. Salomon-Escoto, Steven Hatch, Randall Pellish

Open Access Articles

Background: Tumor necrosis factor alpha (TNFalpha) is a key cytokine in both the pathogenesis of inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) and the host defense against tuberculosis (TB). Consequently, anti-TNFalpha medications result in an increased risk of latent TB infection (LTBI) reactivation. Here, we sought to evaluate the factors affecting the results of QuantiFERON-TB Gold In-Tube (QFT-GIT) assay as a screening tool for LTBI.

Methods: We conducted an observational, retrospective study in patients with IBD and RA who underwent LTBI screening using QFT-GIT at UMass Memorial Medical Center between 2008 and 2016 prior to initiation of anti-TNF medications ...

A Budget Impact Model For Two Investigational Agents For The Treatment Of Nonalcoholic Steatohepatitis, Nicole M. Trask, Pavel Lavitas, Vincent Palumbo

Commonwealth Medicine Publications

Statistics show approximately 15 million Americans suffer from NASH, a nonalcoholic fatty liver disease that is projected to become the most common reason for liver transplantation. There are no FDA approved therapies for NASH, so doctors are forced to treat patients with off-label medications while keeping an eye out for breakthroughs in medication development.

Two novel therapies, obeticholic acid and elafibranor, are currently in Phase III trials. If they receive FDA approval, interest will be high as they will be the first treatments specifically labeled for NASH. We detail a budget impact model for a sample state Medicaid plan in ...

The Association Of Dietary Quality With Colorectal Cancer Among Normal Weight, Overweight And Obese Men And Women: A Prospective Longitudinal Study In The Usa, Rosalie A. Torres Stone, Molly E. Waring, Sarah L. Cutrona, Catarina I. Kiefe, Jeroan J. Allison, Chyke A. Doubeni

Jeroan J. Allison

OBJECTIVE: Lower body mass index (BMI) and higher dietary quality reduce the risk of colorectal cancer (CRC). A full understanding of how these associations vary by sex and weight is lacking.

METHODS: We used data from the National Institutes of Health - American Association of Retired Persons (NIH)-AARP) Diet and Health Study for 398 458 persons who were 50-71 years old in 1995-1996 and followed through 2006. Exposures were dietary quality as reflected by the Mediterranean Diet, the Healthy Eating Index-2010 and the Dietary Approaches to Stop Hypertension score, stratified by BMI category. The outcome was CRC diagnosis from cancer ...

The Association Of Dietary Quality With Colorectal Cancer Among Normal Weight, Overweight And Obese Men And Women: A Prospective Longitudinal Study In The Usa, Rosalie A. Torres Stone, Molly E. Waring, Sarah L. Cutrona, Catarina I. Kiefe, Jeroan J. Allison, Chyke A. Doubeni

Sarah L. Cutrona

OBJECTIVE: Lower body mass index (BMI) and higher dietary quality reduce the risk of colorectal cancer (CRC). A full understanding of how these associations vary by sex and weight is lacking.

METHODS: We used data from the National Institutes of Health - American Association of Retired Persons (NIH)-AARP) Diet and Health Study for 398 458 persons who were 50-71 years old in 1995-1996 and followed through 2006. Exposures were dietary quality as reflected by the Mediterranean Diet, the Healthy Eating Index-2010 and the Dietary Approaches to Stop Hypertension score, stratified by BMI category. The outcome was CRC diagnosis from cancer ...

The Association Of Dietary Quality With Colorectal Cancer Among Normal Weight, Overweight And Obese Men And Women: A Prospective Longitudinal Study In The Usa, Rosalie A. Torres Stone, Molly E. Waring, Sarah L. Cutrona, Catarina I. Kiefe, Jeroan J. Allison, Chyke A. Doubeni

Rosalie A. Torres Stone

OBJECTIVE: Lower body mass index (BMI) and higher dietary quality reduce the risk of colorectal cancer (CRC). A full understanding of how these associations vary by sex and weight is lacking.

METHODS: We used data from the National Institutes of Health - American Association of Retired Persons (NIH)-AARP) Diet and Health Study for 398 458 persons who were 50-71 years old in 1995-1996 and followed through 2006. Exposures were dietary quality as reflected by the Mediterranean Diet, the Healthy Eating Index-2010 and the Dietary Approaches to Stop Hypertension score, stratified by BMI category. The outcome was CRC diagnosis from cancer ...

The Association Of Dietary Quality With Colorectal Cancer Among Normal Weight, Overweight And Obese Men And Women: A Prospective Longitudinal Study In The Usa, Rosalie A. Torres Stone, Molly E. Waring, Sarah L. Cutrona, Catarina I. Kiefe, Jeroan J. Allison, Chyke A. Doubeni

Catarina I. Kiefe

OBJECTIVE: Lower body mass index (BMI) and higher dietary quality reduce the risk of colorectal cancer (CRC). A full understanding of how these associations vary by sex and weight is lacking. METHODS: We used data from the National Institutes of Health - American Association of Retired Persons (NIH)-AARP) Diet and Health Study for 398 458 persons who were 50-71 years old in 1995-1996 and followed through 2006. Exposures were dietary quality as reflected by the Mediterranean Diet, the Healthy Eating Index-2010 and the Dietary Approaches to Stop Hypertension score, stratified by BMI category. The outcome was CRC diagnosis from cancer ...

The Effect Of Ostomate-To-Ostomate Support On Psychosocial Adaptation To Stoma, Marjorie C. Summers

Doctor of Nursing Practice Capstone Projects

Approximately one million people in North America are living with an ostomy, and an additional 100,000 will undergo ostomy surgery annually. Persons living with ostomies, often referred to as ostomates, require specialized care and management to sustain physical health and quality of life. Fecal diversion ostomates, when compared to the general population, are more likely to experience psychological disturbance and higher levels of depression. These ostomates have reported increased loneliness, lowered self-esteem, decreased or absent libido, irritability, suicidal ideation, poor self-image, and symptoms of generalized anxiety disorder and social phobia. Being an ostomate has been associated with a reduction ...

The Association Of Dietary Quality With Colorectal Cancer Among Normal Weight, Overweight And Obese Men And Women: A Prospective Longitudinal Study In The Usa, Rosalie A. Torres Stone, Molly E. Waring, Sarah L. Cutrona, Catarina I. Kiefe, Jeroan J. Allison, Chyke A. Doubeni

Rosalie A. Torres Stone

OBJECTIVE: Lower body mass index (BMI) and higher dietary quality reduce the risk of colorectal cancer (CRC). A full understanding of how these associations vary by sex and weight is lacking.

METHODS: We used data from the National Institutes of Health - American Association of Retired Persons (NIH)-AARP) Diet and Health Study for 398 458 persons who were 50-71 years old in 1995-1996 and followed through 2006. Exposures were dietary quality as reflected by the Mediterranean Diet, the Healthy Eating Index-2010 and the Dietary Approaches to Stop Hypertension score, stratified by BMI category. The outcome was CRC diagnosis from cancer ...

The Association Of Dietary Quality With Colorectal Cancer Among Normal Weight, Overweight And Obese Men And Women: A Prospective Longitudinal Study In The Usa, Rosalie A. Torres Stone, Molly E. Waring, Sarah L. Cutrona, Catarina I. Kiefe, Jeroan J. Allison, Chyke A. Doubeni

Jeroan J. Allison

OBJECTIVE: Lower body mass index (BMI) and higher dietary quality reduce the risk of colorectal cancer (CRC). A full understanding of how these associations vary by sex and weight is lacking.

METHODS: We used data from the National Institutes of Health - American Association of Retired Persons (NIH)-AARP) Diet and Health Study for 398 458 persons who were 50-71 years old in 1995-1996 and followed through 2006. Exposures were dietary quality as reflected by the Mediterranean Diet, the Healthy Eating Index-2010 and the Dietary Approaches to Stop Hypertension score, stratified by BMI category. The outcome was CRC diagnosis from cancer ...