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Early Oral Feeding After Bowel Resection, Jennifer Strang 2018 University of the Incarnate Word

Early Oral Feeding After Bowel Resection, Jennifer Strang

Theses & Dissertations

Research Focus: The primary purpose of this project was to determine if there was an association of factors with time to first solid meal in gastrointestinal (GI) surgery patients and the impact solid diet has on length of stay (LOS) in the hospital, GI symptoms, and incidence of post-operative ileus (POI). A secondary purpose was to observe and describe when an oral diet was started and the progression of diet after GI surgery.

Research Methods: This study was a cross-sectional, retrospective chart review of a convenience sample in a multi-centered hospital system conducted in 84 GI resection patients who were ...


Endoscopic Retrograde Cholangiopancreatography In Cirrhosis - A Systematic Review And Meta-Analysis Focused On Adverse Events, Harmeet Singh Mashiana, Banreet Dhindsa, Ji Won Yoo, Amaninder Singh Dhaliwal, Shailender Singh, Harlan Sayles, Qing Wu, Ali A. Siddiqui, Gordon Ohning, Mohit Girotra, Douglas A. Adler 2018 University of Nevada, Las Vegas

Endoscopic Retrograde Cholangiopancreatography In Cirrhosis - A Systematic Review And Meta-Analysis Focused On Adverse Events, Harmeet Singh Mashiana, Banreet Dhindsa, Ji Won Yoo, Amaninder Singh Dhaliwal, Shailender Singh, Harlan Sayles, Qing Wu, Ali A. Siddiqui, Gordon Ohning, Mohit Girotra, Douglas A. Adler

School of Medicine Faculty Publications

AIM To investigate indications and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) in cirrhotics, especially adverse events. Patients with cirrhosis undergoing ERCP are believed to have increased risk. However, there is a paucity of literature describing the indications and outcomes of ERCP procedures in patients with cirrhosis, especially focusing on adverse events. METHODS We performed a systematic appraisal of major literature databases, including PubMed and EMBASE, with a manual search of literature from their inception until April 2017. RESULTS A total of 6,505 patients from 15 studies were analyzed (male ratio 59%, mean age 59 years), 11% with alcoholic and ...


Upper Gastrointestinal Bleed Embolization With Onyx®: The "Tattoo Effect", Driss Raissi, Qian Yu, S. Houssam Mardini 2018 University of Kentucky

Upper Gastrointestinal Bleed Embolization With Onyx®: The "Tattoo Effect", Driss Raissi, Qian Yu, S. Houssam Mardini

Radiology Faculty Publications

Endoscopic intervention is well validated for the control of upper gastrointestinal bleeding (UGIB). In cases of refractory bleeding, transarterial embolization is a safe and effective alternative. Ethylene vinyl alcohol (EVOH) commonly known as Onyx® is an inherently black liquid embolic approved for use in cerebrovascular arteriovenous malformations and is increasingly used as an embolic agent in multiple peripheral and visceral territories. Onyx® has a uniquely undesirable property of causing black color discoloration when used in peripheral applications adjacent to the skin akin to a "tattoo effect." Knowledge of the agents used by the interventional radiologist, clinical correlation, and close follow-up ...


The Dynamic Roles Of Mesenchymal Stem Cells In Colon Cancer, Shan Wang, Zhiguo Miao, Qiyuan Yang, Yimin Wang, Jinzhou Zhang 2018 Henan Institute of Science and Technology

The Dynamic Roles Of Mesenchymal Stem Cells In Colon Cancer, Shan Wang, Zhiguo Miao, Qiyuan Yang, Yimin Wang, Jinzhou Zhang

Open Access Articles

Colon cancer is still one of the most common causes of cancer in human and is characterized by lymphocyte infiltrates and originates from the epithelial cells found in the lining of colon or rectum of the gastrointestinal tract. Mesenchymal stem cells (MSCs) are composed of the multipotent stem cell group of stroma and can be differentiated as various cell lineages, such as fibroblasts, osteoblasts, and adipocytes. MSCs provide mechanical and structural support and have potential functions during tumor growth and metastasis. The efficacy of MSC-based therapies is partly dependent on the migration and homing of MSCs to tumors and metastatic ...


Comparison Of Outcomes For Supine Vs. Prone Position Ercp: A Systematic Review And Meta-Analysis, Harmeet Singh Mashiana, Mahendran Jayaraj, Babu Pappu Mohan, Gordon Ohning, Douglas G. Adler 2018 University of Nevada, Las Vegas

Comparison Of Outcomes For Supine Vs. Prone Position Ercp: A Systematic Review And Meta-Analysis, Harmeet Singh Mashiana, Mahendran Jayaraj, Babu Pappu Mohan, Gordon Ohning, Douglas G. Adler

School of Medicine Faculty Publications

Background While endoscopic retrograde cholangiopancreatography (ERCP) is usually performed in the prone position, some studies have advocated for ERCP in the supine position. Studies comparing the technical success and safety outcomes have shown variable results. We performed a systematic review and meta-analysis of studies reporting the comparison between the two positions for ERCP outcomes. Methods We conducted a search of electronic databases and conference proceedings including PubMed, EMBASE, and Web of Science databases (from inception through October 2016) to identify studies that reported the comparison of technical success and safety outcomes between supine and prone ERCP. The primary outcome was ...


Video Capsule Endoscopy In The Assessment Of Portal Hypertensive Enteropathy, Yasir Al-Azzawai, Lidia Spaho, Mohammed Mahmoud, Joan Kheder, Anne Foley, David R. Cave 2018 University of Massachusetts Medical School

Video Capsule Endoscopy In The Assessment Of Portal Hypertensive Enteropathy, Yasir Al-Azzawai, Lidia Spaho, Mohammed Mahmoud, Joan Kheder, Anne Foley, David R. Cave

Open Access Articles

Background: The features of the portal hypertension enteropathy (PHE) vary from mild mucosal changes to varices with or without bleeding. The prevalence and the development are not fully understood.

Aim: Our aim is to examine the prevalence and the different manifestations of PHE using video capsule endoscopy (VCE).

Methods: It is a single center retrospective study of patients with cirrhosis, who had VCE. Based on the published literature, we divided the PHE lesions into vascular lesions and mucosal lesions.

Results: Of the 100 patients with cirrhosis that had a VCE study, the mean age was 62.82 years. Male gender ...


A Multi-Institution Consensus On How To Perform Eus-Guided Biliary Drainage For Malignant Biliary Obstruction., Jintao Guo, Marc Giovannini, Anand V. Sahai, Adrian Saftoiu, Christoph F. Dietrich, Erwin Santo, Pietro Fusaroli, Ali Siddiqui, Manoop S. Bhutani, Anthony Yuen Bun Teoh, Atsushi Irisawa, Brenda Lucia Arturo Arias, Chalapathi Rao Achanta, Christian Jenssen, Dong-Wan Seo, Douglas G. Adler, Evangelos Kalaitzakis, Everson Artifon, Fumihide Itokawa, Jan Werner Poley, Girish Mishra, Khek Yu Ho, Hsiu-Po Wang, Hussein Hassan Okasha, Jesse Lachter, Juan J. Vila, Julio Iglesias-Garcia, Kenji Yamao, Kenjiro Yasuda, Kensuke Kubota, Laurent Palazzo, Luis Carlos Sabbagh, Malay Sharma, Mitsuhiro Kida, Mohamed El-Nady, Nam Q. Nguyen, Peter Vilmann, Pramod Kumar Garg, Praveer Rai, Shuntaro Mukai, Silvia Carrara, Sreeram Parupudi, Subbaramiah Sridhar, Sundeep Lakhtakia, Surinder S Rana, Takeshi Ogura, Todd H. Baron, Vinay Dhir, Siyu Sun 2018 Shengjing Hospital of China Medical University

A Multi-Institution Consensus On How To Perform Eus-Guided Biliary Drainage For Malignant Biliary Obstruction., Jintao Guo, Marc Giovannini, Anand V. Sahai, Adrian Saftoiu, Christoph F. Dietrich, Erwin Santo, Pietro Fusaroli, Ali Siddiqui, Manoop S. Bhutani, Anthony Yuen Bun Teoh, Atsushi Irisawa, Brenda Lucia Arturo Arias, Chalapathi Rao Achanta, Christian Jenssen, Dong-Wan Seo, Douglas G. Adler, Evangelos Kalaitzakis, Everson Artifon, Fumihide Itokawa, Jan Werner Poley, Girish Mishra, Khek Yu Ho, Hsiu-Po Wang, Hussein Hassan Okasha, Jesse Lachter, Juan J. Vila, Julio Iglesias-Garcia, Kenji Yamao, Kenjiro Yasuda, Kensuke Kubota, Laurent Palazzo, Luis Carlos Sabbagh, Malay Sharma, Mitsuhiro Kida, Mohamed El-Nady, Nam Q. Nguyen, Peter Vilmann, Pramod Kumar Garg, Praveer Rai, Shuntaro Mukai, Silvia Carrara, Sreeram Parupudi, Subbaramiah Sridhar, Sundeep Lakhtakia, Surinder S Rana, Takeshi Ogura, Todd H. Baron, Vinay Dhir, Siyu Sun

Division of Gastroenterology and Hepatology Faculty Papers

Background and Objectives: EUS-guided biliary drainage (EUS-BD) was shown to be useful for malignant biliary obstruction (MBO). However, there is lack of consensus on how EUS-BD should be performed.

Methods: This was a worldwide multi-institutional survey among members of the International Society of EUS conducted in February 2018. The survey consisted of 10 questions related to the practice of EUS-BD.

Results: Forty-six endoscopists of them completed the survey. The majority of endoscopists felt that EUS-BD could replace percutaneous transhepatic biliary drainage after failure of ERCP. Among all EUS-BD methods, the rendezvous stenting technique should be the first choice. Self-expandable metal ...


Inhibition Of Triggering Receptor Expressed On Myeloid Cells 1 Ameliorates Inflammation And Macrophage And Neutrophil Activation In Alcoholic Liver Disease In Mice, David Tornai, Istvan Furi, Zu T. Shen, Alexander B. Sigalov, Sahin Coban, Gyongyi Szabo 2018 University of Massachusetts Medical School

Inhibition Of Triggering Receptor Expressed On Myeloid Cells 1 Ameliorates Inflammation And Macrophage And Neutrophil Activation In Alcoholic Liver Disease In Mice, David Tornai, Istvan Furi, Zu T. Shen, Alexander B. Sigalov, Sahin Coban, Gyongyi Szabo

Open Access Articles

Alcoholic liver disease (ALD) is characterized by macrophage and neutrophil leukocyte recruitment and activation in the liver. Damage- and pathogen-associated molecular patterns contribute to a self-perpetuating proinflammatory state in ALD. Triggering receptor expressed on myeloid cells 1 (TREM-1) is a surface receptor that amplifies inflammation induced by toll-like receptors (TLRs) and is expressed on neutrophils and monocytes/macrophages. We hypothesized that TREM-1 signaling contributes to proinflammatory pathway activation in ALD. Using an in vivo ALD model in mice, we tested the effects of ligand-independent TREM-1 inhibitory peptides that were formulated into human high-density lipoprotein (HDL)-mimicking complexes GF9-HDL and GA ...


Reduced Gut Microbiome Protects From Alcohol-Induced Neuroinflammation And Alters Intestinal And Brain Inflammasome Expression, Patrick P. Lowe, Benedek Gyongyosi, Abhishek Satishchandran, Arvin Iracheta-Vellve, Yeonhee Cho, Aditya Ambade, Gyongyi Szabo 2018 University of Massachusetts Medical School

Reduced Gut Microbiome Protects From Alcohol-Induced Neuroinflammation And Alters Intestinal And Brain Inflammasome Expression, Patrick P. Lowe, Benedek Gyongyosi, Abhishek Satishchandran, Arvin Iracheta-Vellve, Yeonhee Cho, Aditya Ambade, Gyongyi Szabo

Open Access Articles

BACKGROUND: The end-organ effects of alcohol span throughout the entire body, from the gastrointestinal tract to the central nervous system (CNS). In the intestine, alcohol use changes the microbiome composition and increases gut permeability allowing translocation of microbial components into the circulation. Gut-derived pathogen-associated signals initiate inflammatory responses in the liver and possibly elsewhere in the body. Because previous studies showed that the gut microbiome contributes to alcohol-induced liver disease, we hypothesized that antibiotic administration to reduce the gut microbiome would attenuate alcohol-induced inflammation in the brain and small intestine (SI).

METHODS: Six- to 8-week-old C57BL/6J female mice were ...


Economical Effect Of Lumen Apposing Metal Stents For Treating Benign Foregut Strictures., Alexander Hallac, Wichit Srikureja, Eashen Liu, Parag Dhumal, Ashish Thatte, Nishant Puri 2018 Providence Gastroenterology, Spokane, WA 99204, United States.

Economical Effect Of Lumen Apposing Metal Stents For Treating Benign Foregut Strictures., Alexander Hallac, Wichit Srikureja, Eashen Liu, Parag Dhumal, Ashish Thatte, Nishant Puri

Articles, Abstracts, and Reports

AIM: To evaluate the clinical and economical efficacy of lumen apposing metal stent (LAMS) in the treatment of benign foregut strictures.

METHODS: A single center retrospective database of patients who underwent endoscopic treatment of benign foregut strictures between January 2014 and May 2017 was analyzed. A control group of non-stented patients who underwent three endoscopic dilations was compared to patients who underwent LAMS placement. Statistical tests performed included independent

RESULTS: Nine hundred and ninety-eight foregut endoscopic dilations were performed between January 2014 and May 2017. 15 patients underwent endoscopic LAMS placement for treatment of benign foregut stricture. Thirty-six patients with ...


Fxr And Tgr5 Agonists Ameliorate Liver Injury, Steatosis, And Inflammation After Binge Or Prolonged Alcohol Feeding In Mice, Arvin Iracheta-Vellve, Charles D. Calenda, Jan Petrasek, Aditya Ambade, Karen Kodys, Luciano Adorini, Gyongyi Szabo 2018 University of Massachusetts Medical School

Fxr And Tgr5 Agonists Ameliorate Liver Injury, Steatosis, And Inflammation After Binge Or Prolonged Alcohol Feeding In Mice, Arvin Iracheta-Vellve, Charles D. Calenda, Jan Petrasek, Aditya Ambade, Karen Kodys, Luciano Adorini, Gyongyi Szabo

Open Access Articles

Bile acids (BAs) activate various dedicated receptors, including the farnesoid X receptor (FXR) and the Takeda G protein-coupled receptor 5 (TGR5). The FXR agonist obeticholic acid (OCA) is licensed for the treatment of primary biliary cholangitis and has shown promising results in NASH patients, whereas TGR5 agonists target inflammation and metabolism. We hypothesized that FXR and/or TGR5 agonists may be therapeutic in early alcoholic liver disease (ALD) in mice, in which hepatic inflammation plays a major role. OCA, INT-777, and INT-767 are BA derivatives with selective agonist properties for FXR, TGR5, or both, respectively. These compounds were tested in ...


Over-The-Scope Clip Defect Closure Following Endoscopic Mucosal Resection Throughout The Gastrointestinal Tract: A Case Series, Kyle Kreitman DO, Patrick Hickey DO, Shashin Shah MD, Hiral N. Shah MD 2018 Lehigh Valley Health Network

Over-The-Scope Clip Defect Closure Following Endoscopic Mucosal Resection Throughout The Gastrointestinal Tract: A Case Series, Kyle Kreitman Do, Patrick Hickey Do, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.


The Sensitivity Of Cross-Sectional Imaging For Identifying Periampullary Diverticula, Austin Chiang, MD, MPH, Jetmir Vojnika, MD, Alexander Schlachterman, MD, David E. Loren, MD, Thomas E. Kowalski 2018 Thomas Jefferson University

The Sensitivity Of Cross-Sectional Imaging For Identifying Periampullary Diverticula, Austin Chiang, Md, Mph, Jetmir Vojnika, Md, Alexander Schlachterman, Md, David E. Loren, Md, Thomas E. Kowalski

Division of Gastroenterology and Hepatology Posters

Our aim was to determine the sensitivity of imaging in identifying duodenal diverticula as seen during ERCP.


Real World Experience With Obeticholic Acid For Primary Biliary Cholangitis: A Case Series, Eric Nellis MD, Adam Peyton DO, She-Yan Wong MD 2018 Lehigh Valley Health Network

Real World Experience With Obeticholic Acid For Primary Biliary Cholangitis: A Case Series, Eric Nellis Md, Adam Peyton Do, She-Yan Wong Md

Department of Medicine

No abstract provided.


The Incidental Discovery Of Strongyloidiasis Colitis, Elizabeth Gold DO, Travis Magdaleno MD, Cheryl A. Bloomfield MD 2018 Lehigh Valley Health Network

The Incidental Discovery Of Strongyloidiasis Colitis, Elizabeth Gold Do, Travis Magdaleno Md, Cheryl A. Bloomfield Md

Department of Medicine

No abstract provided.


Pancreatoscopy In Undiagnosed Pancreatic Disease, Travis Magdaleno MD, Shashin Shah MD, Hiral N. Shah MD 2018 Lehigh Valley Health Network

Pancreatoscopy In Undiagnosed Pancreatic Disease, Travis Magdaleno Md, Shashin Shah Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.


Benign Colonic Schwann Cell Hamartoma In A Pediatric Patient With Pten Hamartoma Tumor Syndrome (Phts), Naser Tolaymat MD, Adam R. Paul DO 2018 Lehigh Valley Health Network

Benign Colonic Schwann Cell Hamartoma In A Pediatric Patient With Pten Hamartoma Tumor Syndrome (Phts), Naser Tolaymat Md, Adam R. Paul Do

Department of Medicine

No abstract provided.


A Proposed Therapeutic Algorithm For Colorectal Cancer Prevention, Based On Endoscopic Polypectomies In Patients With Multiple Colonic Polyps, Septimiu Alexandru, Florin D. Ungureanu, Reka Incze Kutasi, Cosmin Alec Moldovan 2018 Witting Clinical Hospital, Department of General Surgery, Bucharest, Romania

A Proposed Therapeutic Algorithm For Colorectal Cancer Prevention, Based On Endoscopic Polypectomies In Patients With Multiple Colonic Polyps, Septimiu Alexandru, Florin D. Ungureanu, Reka Incze Kutasi, Cosmin Alec Moldovan

Journal of Mind and Medical Sciences

Introduction. Results from single medical centers having large numbers of patients with multiple colonic polyps that have undergone colonoscopy management are rare.

Material and method. The present study is based on 2,000 cases enrolled during 2009 and 2017, including patients that underwent colonoscopy for various reasons in the Department for Upper and Lower Endoscopy of Witting Clinical Hospital, Bucharest, Romania.

Results. Of the 2,000 patients examined during 2009 - 2017, 594 tumor formations were detected; 148 (24.9%) patients had colorectal malignancies, and 446 (75%) polypoid formations in 313 patients who had one or more colon polyps were found ...


Thrombocytopenia In End-Stage Renal Disease And Chronic Viral Hepatitis B Or C, Olga Hilda Orasan, Laura Urian, George Ciulei, Iulia Breaban, Andreea Maria Stefan, Sorina Cezara Secara, Adela Sitar Taut, Simina Tarmure Sarlea, Vasile Negrean, Dorel Sampelean, Ioan Mihai Patiu, Remus Aurel Orasan, Angela Cozma 2018 Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, 4 th Medical Department, Cluj-Napoca, Romania

Thrombocytopenia In End-Stage Renal Disease And Chronic Viral Hepatitis B Or C, Olga Hilda Orasan, Laura Urian, George Ciulei, Iulia Breaban, Andreea Maria Stefan, Sorina Cezara Secara, Adela Sitar Taut, Simina Tarmure Sarlea, Vasile Negrean, Dorel Sampelean, Ioan Mihai Patiu, Remus Aurel Orasan, Angela Cozma

Journal of Mind and Medical Sciences

Objectives. We evaluated platelet counts in end-stage renal disease and chronic viral hepatitis.

Materials and Methods. We studied 70 patients with end-stage renal disease and chronic viral hepatitis and compared them to a control group of 45 patients without hepatitis.

Results. The presence of viral hepatitis was associated with a higher prevalence of thrombocytopenia. Correlations between age, C-reactive protein, liver stiffness measurement, and platelet count were observed. C-reactive protein levels > 10 mg/dl were associated with a lower risk of thrombocytopenia in patients with end-stage renal disease and chronic viral hepatitis, yet age > 60 years, dialysis vintage > 10 years, aspartate ...


Strategies To Improve Post-Procedural Safe Patient Handoffs, Marguerite Anderson, Tara Herman, Janice Nichols, Robyn Dixon, Elizabeth Van Der Linden, Bonnie Boivin, Stephen Tyzik, MMC ASU, MMC PACU, SSU, Endoscopy, Advanced Endoscopy, One Call Center 2018 Maine Medical Center

Strategies To Improve Post-Procedural Safe Patient Handoffs, Marguerite Anderson, Tara Herman, Janice Nichols, Robyn Dixon, Elizabeth Van Der Linden, Bonnie Boivin, Stephen Tyzik, Mmc Asu, Mmc Pacu, Ssu, Endoscopy, Advanced Endoscopy, One Call Center

Operational Excellence

STRATEGIES TO IMPROVE SAFE PATIENT HANDOFFS AND POST PROCEDURAL FLOW

During patient transfers from one care unit to another, it is imperative for patient safety and satisfaction that timely and complete communication between staff occurs. In an academic tertiary care medical center, a team consisting of representatives from 6 patient care units used improvement methods of operational excellence to improve patient centered movement.

The goal of this project was to improve the percentages of two questions related to information sharing on the FY2018 AHRQ Culture of Patient Safety Survey. Using baseline metrics to reflect the current state of patient wait ...


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