Digestive System Diseases Commons^™

Identification And Characterization Of Butyrate-Producing Species In The Human Gut Microbiome, Grace Maline

Theses/Capstones/Creative Projects

Inflammatory Bowel Diseases (IBD) including ulcerative colitis, indeterminate colitis, and Crohn’s disease are increasingly common conditions that places a high physical and financial burden on individuals and global healthcare systems. Though many treatments exist for these conditions, their unpredictable nature and causation make them difficult to manage across the variety of IBD patients. Additionally, many of these treatments come with undesirable side effects or modes of delivery. Therefore, it is worthwhile to explore the use of Short Chain Fatty Acids (SCFAs) such as butyrate whose affects in the human gut include decreased inflammation and decreased risk of colorectal cancer ...

Gastric Antral Diverticula: A Rare Diverticula With A Unique Presentation, Pratishtha Singh, Kathleen Raynor, Chadley Froes

Gastroenterology

Gastric diverticula are the least common gastrointestinal diverticula. Patients can be diagnosed incidentally on EGD or present with variable symptoms such as abdominal fullness, anorexia, and perforation. Gastric diverticula can be acquired from malignancy, peptic ulcer disease, or prior surgery or be congenital. Treatment varies based on symptomatology ranging from conservative medical management with proton pump inhibitors to surgical treatment with open or laparoscopic resection. We present a case of a 73-year-old female with acquired gastric diverticulum presenting as a gastric outlet obstruction who was successfully treated with conservative medical therapy.

Virtualized Clinical Studies To Assess The Natural History And Impact Of Gut Microbiome Modulation In Non-Hospitalized Patients With Mild To Moderate Covid-19 A Randomized, Open-Label, Prospective Study With A Parallel Group Study Evaluating The Physiologic Effects Of Kb109 On Gut Microbiota Structure And Function: A Structured Summary Of A Study Protocol For A Randomized Controlled Study [Preprint], John P. Haran, Jose C. Pinero, Yan Zheng, Norma Alonzo Palma, Mark Wingertzahn

COVID-19 Publications by UMMS Authors

These 2 parallel studies (K031 and K032) aim to evaluate the safety of KB109 in addition to supportive self-care (SSC) compared with SSC alone in outpatients with mild to moderate coronavirus disease 2019 (COVID-19). KB109 is a novel synthetic glycan that was formulated to modulate the gut microbiome composition and metabolic output in order to increase beneficial short-chain fatty acid (SCFA) production in the gut. The K031 study is designed to evaluate the safety of KB109 and characterize its impact on the natural progression of COVID-19 in patients with mild to moderate disease. The K032 study is evaluating the effect ...

Esophageal Cancer Complicated By A Distal Acquired Esophagopulmonary Fistula, Alexander D. Lake, Yousef Almuzaini, Aaron Jaffe, Joseph Staffetti, Mukesh Patel

HCA Healthcare Journal of Medicine

Esophageal respiratory fistulas, commonly found as a tracheoesophageal fistula (TEF), are abnormal connections between the esophagus and trachea. These can be congenital (infants) or acquired (malignancy). A more rare form of an esophageal respiratory fistula is an abnormal connection between the esophagus and the lung parenchyma—also known as an esophagopulmonary fistula. In our case, we present a middle-aged male with a history of esophageal cancer undergoing chemotherapy and radiation presenting into the intensive care unit for increasing shortness of breath and vomiting after eating found to have a rare form of a TEF causing his symptoms.

Differential Role Of Mlkl In Alcohol-Associated And Non-Alcohol-Associated Fatty Liver Diseases In Mice And Humans, Tatsunori Miyata, Bruce A. Barton, Laura E. Nagy

University of Massachusetts Medical School Faculty Publications

Hepatocellular death contributes to progression of alcohol-associated (ALD-associated) and non-alcohol-associated (NAFL/NASH) liver diseases. However, receptor-interaction protein kinase 3 (RIP3), an intermediate in necroptotic cell death, contributes to injury in murine models of ALD but not NAFL/NASH. We show here that a differential role for mixed-lineage kinase domain-like protein (MLKL), the downstream effector of RIP3, in murine models of ALD versus NAFL/NASH and that RIP1-RIP3-MLKL can be used as biomarkers to distinguish alcohol-associated hepatitis (AH) from NASH. Phospho-MLKL was higher in livers of patients with NASH compared with AH or healthy controls (HCs). MLKL expression, phosphorylation, oligomerization, and ...

Rising Trend Of Women In Gastroenterology: A Paradigm Shift, Lubna Kamani, Jeanin E Van Hooft

Section of Gastroenterology

No abstract provided.

Effect Of Treatment For Hcv On The Development Of Hcc In A Predominately African American Medical Center Population, Bassem Farah, Yechiel Mor, Sarvani Surapaneni, Brian Rutledge, Hojun Lee, Hajra Khan, Anshu Wadehra, Neel Patel, Paul Naylor, Murray Ehrinpreis, Milton Mutchnick

Medical Student Research Symposium

Introduction

Direct Acting Antivirals (DAA) are effective in Hepatitis C (HCV) patients with cirrhosis, but viral elimination may occur in a setting where the HCC development pathway has already begun. Our objective was to determine whether achieving a sustained virologic response (SVR) prior to diagnosis of hepatocellular carcinoma (HCC) improved outcomes in our predominately African American population.

Methods

We reviewed the medical records of 96 HCV patients diagnosed with HCC between 2015 and 2019 Primary outcomes were defined as either alive, death/hospice, or transplant. Tumor size was measured as non-small (> 5cm or multiple tumors) or small (< 5cm). The study was approved by the WSU IRB and data analysis performed using the SAS-JMP statistical software.

Results

Of the ...

Association Of Presenting Symptoms With Abnormal Laboratory Values For Vector-Borne Illness — Experience In An Urban Gastroenterology Practice, Michael D. Erdman, Niloofar Kossari, Jessica Ye, Kristen H. Reynolds, Emily Blodget, B. Robert Mozayeni, Farshid Sam Rahbar

Journal of Patient-Centered Research and Reviews

Background: In the clinical setting, it is not common practice to consider a vector bite, such as from a tick or flea, to be a contributing factor to chronic digestive symptoms. This article investigates associations we have observed among symptomatic patients and positive blood tests for vector-borne illness (VBI).

Methods: Patients who visited an urban gastroenterology clinic over a 3-year period were retrospectively reviewed. A total of 270 patients presenting with a constellation of digestive symptoms — and who had no apparent digestive pathology and reported no prior diagnosis or treatments for VBI — were analyzed. Before the initial visit, all patients ...

Changes In Body Weight And Serum Albumin Levels In Patients Requiring Home Long-Term Oxygen Therapy, Naomi Kayauchi, Eiji Ojima, Katsunori Kagohashi, Hiroaki Satoh

Asian / Pacific Island Nursing Journal

Purpose: To investigate the long-term changes in body weight and serum albumin levels in patients with respiratory failure, and those with chronic heart failure, who were treated with home long-term oxygen therapy (LTOT) to understand the current status and contribute to future measures.

Methods: Patients with chronic obstructive pulmonary disease (COPD), those with interstitial pneumonia (IP), and those with chronic heart failure (CHF) undergoing home LTOT for 6 months or more between January 2011 and January 2019 were included in the study. Body weight and serum albumin levels were assessed at the start of home LTOT and at the end ...

A Comparison Of The Prevalence Of Cirrhosis In A Hispanic And Non-Hispanic Population Based On Body Mass Index, Alexa Perlick, Abaigeal Thompson, Colton Wayne, Jose Campo Maldonado, Angel Rendon

MEDI 9331 Scholarly Activities Clinical Years

Background and Significance

The obesity epidemic is a growing public health concern. In addition to the already known complications and comorbidities associated with obesity, data suggest that obesity is an independent risk factor for the development of liver disease. ^1,2 However, there is a paucity of data regarding the clinical correlation of obesity and cirrhosis in a predominantly Hispanic population. Therefore, the aim of this study is to investigate the prevalence of cirrhosis stratified by BMI in a predominately Hispanic population.

Materials and Methods

This retrospective single-centered study was approved by the University of Texas Rio Grande Valley institutional ...

Reducing Turnaround Time From Pathology Collection To Patient Awareness In Gastroenterology Practice, Adrianna Hyams

DNP Scholarly Projects

Background: Means of improving the turnaround time from specimen completion to the patient being notified of results are not well known or researched. The aim of this study is to decrease the turnaround time (TAT) from when the specimen is collected to the time the patient is notified from 4 weeks to 2 weeks. This quality improvement project took place in a privately owned gastroenterology office in southern Indiana.

Methods: An exhaustive literature review was completed to determine the best means of improving pathology TAT. The Plan Do Check Act (PDCA) method of quality improvement was used for this project ...

Atypical Presentation Of Acute Appendicitis: A Case Report, Yudhistira Pradnyan Kloping, R. Cita Resti Anantia Putri

The New Ropanasuri Journal of Surgery

Despite the fact that acute appendicitis is one of the most common surgical emergencies worldwide, delays in establishing a diagnosis still occur. We report a case of acute appendicitis with an atypical presentation based on the patient’s clinical and laboratory findings. A 25-year-old male was brought with pain in his right lower quadrant. Pain migration, fever, anorexia, nausea, vomiting, or dysuria were denied. Laboratory results were within normal limits. USG examination was not able to visualize the appendix. An abdominal CT-Scan showed a sign of acute appendicitis. The patient was planned for appendectomy. It is important to not immediately ...

In Silico Modelling For The Treatment Of Gastric Cancer, Leonardo F. Martinez, Diana Gamboa, Paul A. Valle

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.

Exploring Peer Mentoring In Pediatric Transition: Perspectives Of Different Stakeholders About Accompanying Patients In Gastroenterology, Guillaume Dumais-Lévesque, Marie-Pascale Pomey

Patient Experience Journal

The literature identifies several issues in the pediatric transition, such as the lack of coordination between pediatric and adult settings and young patients who are not exercising independence in the self-management of their disease. The objective of this study is to explore the potential for a pediatric transition program in gastroenterology, introducing an accompanying patient program to support the transition. A qualitative case study was conducted, including semi-structured focus groups and individual interviews with each group involved in the pediatric transition between two centres in Quebec. A thematic analysis of the collected data was performed using QDA Miner v5.1 ...

Dysbiosis In A Canine Model Of Human Fistulizing Crohn's Disease, Ana Maldonado-Contreras, Lluis Ferrer, Caitlin Cawley, Sarah Crain, Shakti Bhattarai, Juan Toscano, Doyle V. Ward, Andrew Hoffman

Open Access Publications by UMMS Authors

Crohn's disease (CD) is a chronic immune-mediated inflammatory condition caused by the loss of mucosal tolerance toward the commensal microbiota. On average, 29.5% and 42.7% CD patients experience perianal complications at 10 and 20 y after diagnosis, respectively. Perianal CD (pCD) result in high disease burden, diminished quality of life, and elevated health-care costs. Overall pCD are predictors of poor long-term outcomes. Animal models of gut inflammation have failed to fully recapitulate the human manifestations of fistulizing CD. Here, we evaluated dogs with spontaneous canine anal furunculosis (CAF), a disease with clinical similarities to pCD, as a ...

Roles Of Adipokines In Digestive Diseases: Markers Of Inflammation, Metabolic Alteration And Disease Progression, Ming-Ling Chang, Zinger Yang, Sien-Sing Yang

Open Access Publications by UMMS Authors

Adipose tissue is a highly dynamic endocrine tissue and constitutes a central node in the interorgan crosstalk network through adipokines, which cause pleiotropic effects, including the modulation of angiogenesis, metabolism, and inflammation. Specifically, digestive cancers grow anatomically near adipose tissue. During their interaction with cancer cells, adipocytes are reprogrammed into cancer-associated adipocytes and secrete adipokines to affect tumor cells. Moreover, the liver is the central metabolic hub. Adipose tissue and the liver cooperatively regulate whole-body energy homeostasis via adipokines. Obesity, the excessive accumulation of adipose tissue due to hyperplasia and hypertrophy, is currently considered a global epidemic and is related ...

Associations Between Household-Level Exposures And All-Cause Diarrhea And Pathogen-Specific Enteric Infections In Children Enrolled In Five Sentinel Surveillance Studies, Josh M. Colston, Abu S G. Faruque, M Jahangir Hossain, Debasish Saha, Suman Kanungo, Inácio Mandomando, Muhammad Imran Nisar, Anita K. M. Zaidi, Richard Omore, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Diarrheal disease remains a major cause of childhood mortality and morbidity causing poor health and economic outcomes. In low-resource settings, young children are exposed to numerous risk factors for enteric pathogen transmission within their dwellings, though the relative importance of different transmission pathways varies by pathogen species. The objective of this analysis was to model associations between five household-level risk factors-water, sanitation, flooring, caregiver education, and crowding-and infection status for endemic enteric pathogens in children in five surveillance studies. Data were combined from 22 sites in which a total of 58,000 stool samples were tested for 16 specific enteropathogens ...

Investigating Microbial And Host Factors That Modulate Severity Of Clostridioides Difficile Associated Disease, Armando Lerma

Dissertations, Theses, & Student Research in Food Science and Technology

Clostridioides difficile is recognized as one of the most important pathogens in hospital and community healthcare settings. The clinical outcome of infection of toxigenic C. difficile infection (CDI) ranges from asymptomatic colonization to fulminant pseudomembranous colitis and death. In recent studies, it has been suggested that a high proportion of nosocomial CDI cases are transmitted from asymptomatic carriers which might be acting as infection reservoirs. Understanding what causes the different responses to infection could lead to the development of novel prevention and treatment strategies. Although several explanations have been proposed to explain variations in susceptibility, understanding of the exact mechanisms ...

Maternal Inflammatory Bowel Disease, Racial Diversity And Adverse Birth Outcomes, Zubair Saeed, Hany Aly, Charles Macri, Dinan Abdelatif, Mohamed A. Mohamed

Proceedings in Obstetrics and Gynecology

Background: Inflammatory bowel disease (IBD) is a term used to describe two conditions, Crohn’s disease and ulcerative colitis (UC), that currently have no definite cure. The incidence of IBD worldwide has increased, frequently affecting women during their reproductive years.

Objectives: This study examines the association of Crohn's disease and ulcerative colitis (UC) with adverse pregnancy outcomes and looks at the interactions of race/ethnicity on these associations.

Study Design: We examined hospital birth records in the National Inpatient Sample (NIS) data sets in 2011 and 2012. We identified maternal demographics and clinical characteristics using international classification of disease-9 ...

A Case Of Plesiomonas Bacteremia Without Reported Freshwater Exposure, Abigail E. Mcdonald

HCA Healthcare Journal of Medicine

Introduction: Plesiomonas shigelloides is a member of the Enterobacteriaceae family generally found in freshwater. There is little substantive data about the prevalence or distribution of Plesiomonas within the United States. Plesiomonas are most commonly associated with mild, self-limited watery diarrhea among healthy individuals followed by infective colitis. Bacteremia is the most common extraintestinal manifestation of Plesiomonas. Few cases of Plesiomonas bacteremia can be found in the literature.

Clinical Findings: An elderly female with multiple comorbidities was admitted to our hospital for evaluation of generalized cramping abdominal pain of several days duration. She denied any freshwater or saltwater exposure. The patient ...