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The Intersection Of Diarrheal Disease And The Wash Sector: A Case Study Of The Betafo Area In The Vakinankaratra Region, Stephanie Hansen 2017 SIT Study Abroad

The Intersection Of Diarrheal Disease And The Wash Sector: A Case Study Of The Betafo Area In The Vakinankaratra Region, Stephanie Hansen

Stephanie L. Hansen

Diarrheal disease is a leading cause of death in Madagascar, with the highest rates of morbidity and mortality in children under-five. Globally, it is the second leading cause of death of children under-five. The prevalence of diarrheal disease is a direct result of inadequate WASH infrastructure in Madagascar, where 48% of the population has no access to safe drinking water and 79% of the population has no access to improved sanitation (WaterAid, 2015). The inaccessibility of medical services in Madagascar is the largest impediment for diarrhea victims seeking treatment; a quarter of the Malagasy population lives 1 to 2 hours ...


5 Year Expression And Neutrophil Defect Repair After Gene Therapy In Alpha-1 Antitrypsin Deficiency, Christian Mueller, Gwladys Gernoux, Alisha M. Gruntman, Florie Borel, Emer P. Reeves, Roberto Calcedo, Farshid N. Rouhani, Anthony Yachnis, Margaret Humphries, Martha Campbell-Thompson, Louis M. Messina, Jeffrey D. Chulay, Bruce Trapnell, James M. Wilson, Noel G. McElvaney, Terence R. Flotte 2017 University of Massachusetts Medical School

5 Year Expression And Neutrophil Defect Repair After Gene Therapy In Alpha-1 Antitrypsin Deficiency, Christian Mueller, Gwladys Gernoux, Alisha M. Gruntman, Florie Borel, Emer P. Reeves, Roberto Calcedo, Farshid N. Rouhani, Anthony Yachnis, Margaret Humphries, Martha Campbell-Thompson, Louis M. Messina, Jeffrey D. Chulay, Bruce Trapnell, James M. Wilson, Noel G. Mcelvaney, Terence R. Flotte

Christian Mueller

Alpha-1 antitrypsin deficiency is a monogenic disorder resulting in emphysema due principally to the unopposed effects of neutrophil elastase. We previously reported achieving plasma wild-type alpha-1 antitrypsin concentrations at 2.5%-3.8% of the purported therapeutic level at 1 year after a single intramuscular administration of recombinant adeno-associated virus serotype 1 alpha-1 antitrypsin vector in alpha-1 antitrypsin deficient patients. We analyzed blood and muscle for alpha-1 antitrypsin expression and immune cell response. We also assayed previously reported markers of neutrophil function known to be altered in alpha-1 antitrypsin deficient patients. Here, we report sustained expression at 2.0%-2 ...


5 Year Expression And Neutrophil Defect Repair After Gene Therapy In Alpha-1 Antitrypsin Deficiency, Christian Mueller, Gwladys Gernoux, Alisha M. Gruntman, Florie Borel, Emer P. Reeves, Roberto Calcedo, Farshid N. Rouhani, Anthony Yachnis, Margaret Humphries, Martha Campbell-Thompson, Louis M. Messina, Jeffrey D. Chulay, Bruce Trapnell, James M. Wilson, Noel G. McElvaney, Terence R. Flotte 2017 University of Massachusetts Medical School

5 Year Expression And Neutrophil Defect Repair After Gene Therapy In Alpha-1 Antitrypsin Deficiency, Christian Mueller, Gwladys Gernoux, Alisha M. Gruntman, Florie Borel, Emer P. Reeves, Roberto Calcedo, Farshid N. Rouhani, Anthony Yachnis, Margaret Humphries, Martha Campbell-Thompson, Louis M. Messina, Jeffrey D. Chulay, Bruce Trapnell, James M. Wilson, Noel G. Mcelvaney, Terence R. Flotte

University of Massachusetts Medical School Faculty Publications

Alpha-1 antitrypsin deficiency is a monogenic disorder resulting in emphysema due principally to the unopposed effects of neutrophil elastase. We previously reported achieving plasma wild-type alpha-1 antitrypsin concentrations at 2.5%-3.8% of the purported therapeutic level at 1 year after a single intramuscular administration of recombinant adeno-associated virus serotype 1 alpha-1 antitrypsin vector in alpha-1 antitrypsin deficient patients. We analyzed blood and muscle for alpha-1 antitrypsin expression and immune cell response. We also assayed previously reported markers of neutrophil function known to be altered in alpha-1 antitrypsin deficient patients. Here, we report sustained expression at 2.0%-2 ...


The Clinical, Endoscopic And Histological Spectrum Of The Solitary Rectal Ulcer Syndrome: A Single-Center Experience Of 116 Cases, Shahab Abid, Ali Khawaja, Salima Ahmed Bhimani, Zubair Ahmad, Saeed Hamid, Wasim Jafri 2017 Aga Khan University

The Clinical, Endoscopic And Histological Spectrum Of The Solitary Rectal Ulcer Syndrome: A Single-Center Experience Of 116 Cases, Shahab Abid, Ali Khawaja, Salima Ahmed Bhimani, Zubair Ahmad, Saeed Hamid, Wasim Jafri

Zubair Ahmad

Background Solitary rectal ulcer syndrome (SRUS) is an uncommon although benign defecation disorder. The aim of this study was to evaluate the variable endoscopic manifestations of SRUS and its association with other diseases. Methods All the patients diagnosed with SRUS histologically from January 1990 to February 2011 at The Aga Khan University, Karachi were included in the study. The medical records were reviewed retrospectively to evaluate the clinical spectrum of the patients along with the endoscopic and histological findings. Results A total of 116 patients were evaluated. The mean age was 37.4 ± 16.6 (range: 13–80) years, 61 ...


Gastric Juice For The Diagnosis Of H Pylori Infection In Patients On Proton Pump Inhibitors, Javed Yakoob, Shahid Rasool, Z Abbas, Wasim Jafri, Shahab Abid, Muhammad Islam, Zubair Ahmad 2017 Aga Khan University

Gastric Juice For The Diagnosis Of H Pylori Infection In Patients On Proton Pump Inhibitors, Javed Yakoob, Shahid Rasool, Z Abbas, Wasim Jafri, Shahab Abid, Muhammad Islam, Zubair Ahmad

Zubair Ahmad

Aim:To determine the efficacy of gastric juice polymerase chain reaction (PCR) for the detection of H pylori infection in comparison with histology and gastric antral biopsy PCR in Patients on a proton pump inhibitor (PPI). Methods: Eighty-five consecutive Patients with dyspeptic symptoms were enrolled. Gastric biopsies for histology, PCR and gastric juice were collected at endoscopy for PCR of the H pylori urease C gene (ure C). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, positive and negative likelihood ratio for PCR of gastric juice for the H pylori ure C gene was compared to histology ...


Cytokine Changes In Colonic Mucosa Associated With Blastocystis Spp. Subtypes 1 And 3 In Diarrhoea-Predominant Irritable Bowel Syndrome, Javed Yakoob, Zaigham Abbas, Muhammad Waqas Usman, Aisha Sultana, Muhammad Islam, Safia Awan, Zubair Ahmad, Saeed Hamid, Wasim Jafri 2017 Aga Khan University

Cytokine Changes In Colonic Mucosa Associated With Blastocystis Spp. Subtypes 1 And 3 In Diarrhoea-Predominant Irritable Bowel Syndrome, Javed Yakoob, Zaigham Abbas, Muhammad Waqas Usman, Aisha Sultana, Muhammad Islam, Safia Awan, Zubair Ahmad, Saeed Hamid, Wasim Jafri

Zubair Ahmad

We determined cytokines (e.g. interleukin-8, 10, 12 and TNF-α) expression by peripheral blood mononuclear cells (PBMCs) and in rectal mucosa in diarrhoea-predominant irritable bowel syndrome (D-IBS) with Blastocystis spp. Eighty patients with D-IBS and Blastocystis spp. infection were classified as 'cases' and 80 with D-IBS without Blastocystis spp. infection were classified as 'control'. Cases were subdivided into D-IBS and Blastocystis sp. defined type 1 (subtype-specific primer SB83) and type 3 (SB227). Stool microscopy and culture were performed. Rectal biopsies were obtained for histology and cytokines by real-time PCR for mRNA expression of cytokines. PBMCs IL-8 was similar in different ...


Low Rate Of Recurrence Of Helicobacter Pylori Infection In Spite Of High Clarithromycin Resistance In Pakistan, Javed Yakoob, Shahab Abid, Wasim Jafri, Zaigham Abbas, Khalid Mumtaz, Saeed Hamid, Rashida Ahmed 2017 Aga Khan University

Low Rate Of Recurrence Of Helicobacter Pylori Infection In Spite Of High Clarithromycin Resistance In Pakistan, Javed Yakoob, Shahab Abid, Wasim Jafri, Zaigham Abbas, Khalid Mumtaz, Saeed Hamid, Rashida Ahmed

Rashida Ahmed

Background The aim was to investigate the reinfection rate of H. pylori during a follow-up period of 12 months in adults who had undergone eradication therapy. Methods One hundred-twenty patients; 116 with gastritis, 3 with duodenal ulcer and 1 gastric ulcer, were studied. Their mean age was 41 ± 13 years (range 18–77) and male: female ratio of 2:1. H. pylori were cultured and antibiotic sensitivity was determined by Epsilometer test (E-test) for clarithromycin (CLR) and amoxicillin (AMX). Primers of urease C gene of H. pylori and Sau-3 and Hha I restriction enzymes were used for polymerase chain reaction-restriction ...


Frequent Cannabis Users Have Reduced Odds For Non Alcoholic Fatty Liver Disease, Adeyinka Adejumo, Nnaemeka Onyeakusi, Samson Alliu, Ogooluwa A. Ojelabi 2017 University of Massachusetts Medical School

Frequent Cannabis Users Have Reduced Odds For Non Alcoholic Fatty Liver Disease, Adeyinka Adejumo, Nnaemeka Onyeakusi, Samson Alliu, Ogooluwa A. Ojelabi

UMass Center for Clinical and Translational Science Research Retreat

Background: Cannabis is the world's most widely used illicit drug. Though marijuana use has been revealed to impact the prevalence of diabetes, hypertension, and obesity - established risk factors for Non-Alcoholic Fatty Liver (NAFLD), it's relationship with NAFLD remains unknown.

Aim: We sought to investigate the association between cannabis use and NAFLD.

Methods: From the National Health and Nutrition Examination Survey (NHANES III, 1988–1994) survey data, we retrieved data from individuals aged 20 to 60 years who had an abdominal ultrasound for evaluation for hepatic steatosis (n=10,682). We then identified three cannabis use groups: never used ...


The Utilization Of Video Capsule Endoscopy In Patients With Peutz-Jeghers Syndrome, Yasir Al-Azzawai, Erik Holzwanger, David R. Cave 2017 University of Massachusetts Medical School

The Utilization Of Video Capsule Endoscopy In Patients With Peutz-Jeghers Syndrome, Yasir Al-Azzawai, Erik Holzwanger, David R. Cave

UMass Center for Clinical and Translational Science Research Retreat

AIM: Our aim is to demonstrate the utilization of VCE in the patients with Peutz–Jeghers syndrome (PJS) and evaluate the distribution of the polyps in each part of the small intestine and the percentage of patients with PJS who developed complications.

METHODS: Single center, retrospective chart review study of outpatients with PJS who underwent a video capsule endoscopy study between January 2006 and January2016.

RESULTS: A total of 16 patients were identified with PJS; mean age was 40 years. Female gender was predominant with 9 patients. Polyps were found in the duodenum, jejunum and ileum in 33%, 80% and ...


Cannabis Use Is Associated With Reduced Prevalence Of Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study, Adeyinka Adejumo, Samson Alliu, Tokunbo Opeyemi Ajayi, Kelechi Lauretta Adejumo, Oluwole Muyiwa Adegbala, Nnaemeka Egbuna Onyeakusi, Akintunde Micheal Akinjero, Modupeoluwa Durojaiye, Terence N. Bukong 2017 University of Massachusetts Medical School

Cannabis Use Is Associated With Reduced Prevalence Of Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study, Adeyinka Adejumo, Samson Alliu, Tokunbo Opeyemi Ajayi, Kelechi Lauretta Adejumo, Oluwole Muyiwa Adegbala, Nnaemeka Egbuna Onyeakusi, Akintunde Micheal Akinjero, Modupeoluwa Durojaiye, Terence N. Bukong

Open Access Articles

Cannabis use is associated with reduced prevalence of obesity and diabetes mellitus (DM) in humans and mouse disease models. Obesity and DM are a well-established independent risk factor for non-alcoholic fatty liver disease (NAFLD), the most prevalent liver disease globally. The effects of cannabis use on NAFLD prevalence in humans remains ill-defined. Our objective is to determine the relationship between cannabis use and the prevalence of NAFLD in humans. We conducted a population-based case-control study of 5,950,391 patients using the 2014 Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Survey (NIS) discharge records of patients 18 years and ...


Alcohol-Related Changes In The Intestinal Microbiome Influence Neutrophil Infiltration, Inflammation And Steatosis In Early Alcoholic Hepatitis In Mice, Patrick Lowe, Benedek Gyongyosi, Abhishek Satishchandran, Arvin Iracheta-Vellve, Aditya Ambade, Karen Kodys, Donna Catalano, Doyle V. Ward, Gyongyi Szabo 2017 University of Massachusetts Medical School

Alcohol-Related Changes In The Intestinal Microbiome Influence Neutrophil Infiltration, Inflammation And Steatosis In Early Alcoholic Hepatitis In Mice, Patrick Lowe, Benedek Gyongyosi, Abhishek Satishchandran, Arvin Iracheta-Vellve, Aditya Ambade, Karen Kodys, Donna Catalano, Doyle V. Ward, Gyongyi Szabo

University of Massachusetts Medical School Faculty Publications

BACKGROUND: Alcohol-induced intestinal dysbiosis disrupts homeostatic gut-liver axis function and is essential in the development of alcoholic liver disease. Here, we investigate changes in enteric microbiome composition in a model of early alcoholic steatohepatitis and dissect the pathogenic role of intestinal microbes in alcohol-induced liver pathology.

MATERIALS AND METHODS: Wild type mice received a 10-day diet that was either 5% alcohol-containing or an isocaloric control diet plus a single binge. 16S rDNA sequencing defined the bacterial communities in the cecum of alcohol- and pair-fed animals. Some mice were treated with an antibiotic cocktail prior to and throughout alcohol feeding. Liver ...


Outcomes In Necrotizing Enterocolitis (Nec) Treated With Granulocyte Colony Stimulating Factor (Gcsf) And Intravenous Immunoglobulin (Ivig) Vs Standard Of Care Alone: Rct Interim Safety Analysis, Sanjeet Panda, Courtney Briggs-Steinberg, Brian DeBenedictis, Sri Narayana, Edmund F. La Gamma 2017 New York Medical College

Outcomes In Necrotizing Enterocolitis (Nec) Treated With Granulocyte Colony Stimulating Factor (Gcsf) And Intravenous Immunoglobulin (Ivig) Vs Standard Of Care Alone: Rct Interim Safety Analysis, Sanjeet Panda, Courtney Briggs-Steinberg, Brian Debenedictis, Sri Narayana, Edmund F. La Gamma

NYMC Faculty Posters

No abstract provided.


Histamine Intolerance: Why Freshness Matters, Georgia Ede 2017 Smith College

Histamine Intolerance: Why Freshness Matters, Georgia Ede

Journal of Evolution and Health

No abstract provided.


Assessment Of Diet In Patients With Inflammatory Bowel Disease: A Collaboration Of Behavioral And Basic Scientists, Barbara C. Olendzki, Aparna Kohli, Effie Olendzki, YuShuan (Cindy) Lai, Ana Maldonado-Contreras 2017 University of Massachusetts Medical School

Assessment Of Diet In Patients With Inflammatory Bowel Disease: A Collaboration Of Behavioral And Basic Scientists, Barbara C. Olendzki, Aparna Kohli, Effie Olendzki, Yushuan (Cindy) Lai, Ana Maldonado-Contreras

Community Engagement and Research Symposia

Introduction: Clinical research to develop treatment for inflammatory bowel disease (IBD) is focusing on a nutritional regimen restricting certain carbohydrates while incorporating the use of an optimal diet that includes pre- and probiotic foods. Current assessments are not able to measure elements of this nutritional regimen, thus we developed a food frequency questionnaire (FFQ). This FFQ will be utilized in a prospective study of IBD patients following an anti-inflammatory diet (IBD-AID) developed by us and used clinically at UMASS. We will track the bacterial communities inhabiting the microbiome of patients to determine diet-dependent changes, and their relation with patient wellbeing ...


Class I-Restricted T-Cell Responses To A Polymorphic Peptide In A Gene Therapy Clinical Trial For Alpha-1-Antitrypsin Deficiency, Roberto Calcedo, Suryanarayan Somanathan, Qiuyue Qin, Michael R. Betts, Andrew J. Rech, Robert H. Vonderheide, Christian Mueller, Terence R. Flotte, James M. Wilson 2017 University of Pennsylvania

Class I-Restricted T-Cell Responses To A Polymorphic Peptide In A Gene Therapy Clinical Trial For Alpha-1-Antitrypsin Deficiency, Roberto Calcedo, Suryanarayan Somanathan, Qiuyue Qin, Michael R. Betts, Andrew J. Rech, Robert H. Vonderheide, Christian Mueller, Terence R. Flotte, James M. Wilson

Pediatric Publications and Presentations

Adeno-associated virus (AAV)-mediated gene therapy is currently being pursued as a treatment for the monogenic disorder alpha-1-antitrypsin (AAT) deficiency. Results from phase I and II studies have shown relatively stable and dose-dependent increases in transgene-derived wild-type AAT after local intramuscular vector administration. In this report we describe the appearance of transgene-specific T-cell responses in two subjects that were part of the phase II trial. The patient with the more robust T-cell response, which was associated with a reduction in transgene expression, was characterized more thoroughly in this study. We learned that the AAT-specific T cells in this patient were ...


Vitamin D Status In Pediatric Irritable Bowel Syndrome, Benjamin U. Nwosu, Louise Maranda, Ninfa Candela 2017 University of Massachusetts Medical School

Vitamin D Status In Pediatric Irritable Bowel Syndrome, Benjamin U. Nwosu, Louise Maranda, Ninfa Candela

Endocrinology/Diabetes

IMPORTANCE: Irritable bowel syndrome (IBS) is associated with significant morbidity in children and adolescents, and the therapeutic efficacy of available treatment options is limited. The role of vitamin D supplementation in pediatric IBS is unclear as the vitamin D status of pediatric patients with IBS is unknown. Equally, the relationship of vitamin D status with psychosomatic symptoms in children and adolescents is unclear.

AIM: To characterize the vitamin D status of pediatric patients with IBS using a case-control study design.

HYPOTHESIS: Serum 25-hydroxyvitamin D [25(OH)D] concentration will be similar between patients with IBS and controls.

SUBJECTS AND METHODS ...


Risk Of Gastrointestinal Bleeding Among Dabigatran Users - A Self Controlled Case Series Analysis, Wenze Tang, Hsien-Yen Chang, Meijia Zhou, Sonal Singh 2017 The George Washington University Law School

Risk Of Gastrointestinal Bleeding Among Dabigatran Users - A Self Controlled Case Series Analysis, Wenze Tang, Hsien-Yen Chang, Meijia Zhou, Sonal Singh

Open Access Articles

This article aims to evaluate the real world risk of gastrointestinal bleeding among users naive to dabigatran. We adopted a self-controlled case series design. We sampled 1215 eligible adult participants who were continuous insured users between July 1, 2010 and March 31, 2012 with use of dabigatran and at least one gastrointestinal bleeding episode. We used a conditional Poisson regression to estimate incidence rate ratios. The population consisted of 64.69% of male and 60.25% patients equal to or greater than age 65 at start of observation. After adjustment for time-variant confounders, the incidence rate of gastrointestinal bleeding was ...


Evaluation Of Preoperative Anemia And Transfusion Requirements In Adult Liver Transplant Recipients, Parissa M.N. Moghimi, Erika A. Aldag, Rachel Pedersen, Ajay Sahajpal, Jacob N. Clendenon, Vikraman Gunabushanam, Mehraboon S. Irani, David J. Kramer 2016 Department of Pharmacy, Aurora Health Care

Evaluation Of Preoperative Anemia And Transfusion Requirements In Adult Liver Transplant Recipients, Parissa M.N. Moghimi, Erika A. Aldag, Rachel Pedersen, Ajay Sahajpal, Jacob N. Clendenon, Vikraman Gunabushanam, Mehraboon S. Irani, David J. Kramer

Journal of Patient-Centered Research and Reviews

Background: Liver transplantation is often associated with massive blood loss due to surgical complexity and the hemostatic abnormalities of end-stage liver disease. Blood transfusions have been associated with increased risk of infection, multiorgan dysfunction, graft loss and mortality.

Purpose: To determine for liver transplantation whether correlation exists between preoperative anemia and transfusion requirements, length of stay or incidence of postoperative infection.

Methods: A retrospective review of liver transplantations from Jan. 1, 2012, to June 30, 2015, was conducted. Packed red blood cell (PRBC), fresh frozen plasma (FFP), platelet and cryoprecipitate units were collected preoperatively, intraoperatively and within the first 48 ...


Seasonal Variations And Trends In Hospitalization For Peptic Ulcer Disease In The United States: A 12-Year Analysis Of The Nationwide Inpatient Sample, Ritesh Kanotra, Moiz Ahmed, Nileshkumar Patel, Badal Thakkar, Shantanu Solanki, Sarah Tareen, Matthew J. Fasullo, Mayurathan Kesavan, Nikhil Nalluri, Ahsan Khan, Dhaval Pau, Liliane Deeb, Jeffrey Abergel, Ananya Das 2016 Banner Baywood Medical Center

Seasonal Variations And Trends In Hospitalization For Peptic Ulcer Disease In The United States: A 12-Year Analysis Of The Nationwide Inpatient Sample, Ritesh Kanotra, Moiz Ahmed, Nileshkumar Patel, Badal Thakkar, Shantanu Solanki, Sarah Tareen, Matthew J. Fasullo, Mayurathan Kesavan, Nikhil Nalluri, Ahsan Khan, Dhaval Pau, Liliane Deeb, Jeffrey Abergel, Ananya Das

Open Access Articles

BACKGROUND: Peptic ulcer disease (PUD) is a major public health burden significantly impacting the cost of hospitalization in the United States (US). We examined the trends, characteristics, complications, cost, and seasonality of PUD-related hospitalizations from 2000 to 2011.

METHODS: With the use of the Nationwide Inpatient Sample from 2000 through 2011, we identified PUD-related hospitalizations using the International Classification of Diseases (ICD-9), 9th Revision, and the Clinical Modification code 531.00 to 534.91 as the principal discharge diagnosis. The total number of hospitalizations for each calendar month of the year were added over a 12-year period, and this number ...


Data From: Vitamin D Status In Pediatric Irritable Bowel Syndrome, Benjamin U. Nwosu, Louise S. Maranda, Ninfa Candela 2016 University of Massachusetts Medical School

Data From: Vitamin D Status In Pediatric Irritable Bowel Syndrome, Benjamin U. Nwosu, Louise S. Maranda, Ninfa Candela

Pediatric Research Data

Manuscript abstract:

IMPORTANCE: Irritable bowel syndrome (IBS) is associated with significant morbidity in children and adolescents, and the therapeutic efficacy of available treatment options is limited. The role of vitamin D supplementation in pediatric IBS is unclear as the vitamin D status of pediatric patients with IBS is unknown. Equally, the relationship of vitamin D status with psychosomatic symptoms in children and adolescents is unclear.

AIM: To characterize the vitamin D status of pediatric patients with IBS using a case-control study design.

HYPOTHESIS: Serum 25-hydroxyvitamin D [25(OH)D] concentration will be similar between patients with IBS and controls.

SUBJECTS ...


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