Medical Specialties Commons^™

Methylation Signatures In Peripheral Blood Are Associated With Marked Age Acceleration And Disease Progression In Patients With Primary Sclerosing Cholangitis., Michael Trauner, Yevgeniy Gindin, Zhaoshi Jiang, Chuhan Chung, G Mani Subramanian, Robert P Myers, Aliya Gulamhusein, Kris V Kowdley, Cynthia Levy, Zachary Goodman, Michael P Manns, Andrew J Muir, Christopher L Bowlus

Articles, Abstracts, and Reports

Background & Aims: A DNA methylation (DNAm) signature derived from 353 CpG sites (the Horvath clock) has been proposed as an epigenetic measure of chronological and biological age. This epigenetic signature is accelerated in diverse tissue types in various disorders, including non-alcoholic steatohepatitis, and is associated with mortality. Here, we assayed whole blood DNAm to explore age acceleration in patients with primary sclerosing cholangitis (PSC).

Methods: Using the MethylationEPIC BeadChip (850K) array, DNAm signatures in whole blood were analyzed in 36 patients with PSC enrolled in a 96-week trial of simtuzumab (Ishak F0-1, n = 13; F5-6, n = 23). …

Metastatic Leiomyosarcoma Presenting As Polycystic Liver Disease, Michael Burkholz Do, Apurva Modi Md

Gastroenterology

No abstract provided.

Proteome Alterations In Pancreatic Ductal Adenocarcinoma, Sheng Pan, Teresa A Brentnall, Ru Chen

Faculty, Staff and Students Publications

Proteins are the essential functional biomolecules profoundly implicated in all aspects of pancreatic tumorigenesis and its progression. While common genomic factors, such as KRAS, TP53, SMAD4, and CDKN2A have been well recognized in association of pancreatic ductal adenocarcinoma (PDAC), our understanding of functional changes at the proteome level merits further investigation. Malignance associated proteome alterations can be attributed to the convoluted outcomes from genetic, epigenetic and environmental factors in initiating and progressing PDAC, and may reflect on changes in protein expressional level, structure, localization, as well as post-translational modifications (PTMs) status. The study of localized or systemic proteome alterations in …

Edge In Roux-En-Y Gastric Bypass: How Does It Compare To Laparoscopy-Assisted And Balloon Enteroscopy Ercp: A Systematic Review And Meta-Analysis, Banreet Singh Dhindsa, Amaninder Dhaliwal, Babu P. Mohan, Harmeet Singh Mashiana, Mohit Girotra, Gordon Ohning, Ishfaq Bhat, Douglas G. Adler

School of Medicine Faculty Research

Background and study aims Endoscopic ultrasound-directed transgastric ERCP (EDGE) is a new endoscopic procedure to perform ERCP in Roux-en-y gastric bypass (RYGB) patients. The aim of this study was to conduct a systematic review and meta-analysis to evaluate technical success, clinical success and adverse effects of EDGE and compare it to laparoscopic ERCP (LA-ERCP) and balloon ERCP (BE-ERCP). Patients and methods We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google-Scholar, LILACS, SCOPUS, and Web of Science databases to identify studies reporting on EDGE, LA-ERCP, and BE-ERCP. The primary outcome was to evaluate technical and …

Micom: Metagenome-Scale Modeling To Infer Metabolic Interactions In The Gut Microbiota., Christian Diener, Sean M Gibbons, Osbaldo Resendis-Antonio

Articles, Abstracts, and Reports

Compositional changes in the gut microbiota have been associated with a variety of medical conditions such as obesity, Crohn's disease, and diabetes. However, connecting microbial community composition to ecosystem function remains a challenge. Here, we introduce MICOM, a customizable metabolic model of the human gut microbiome. By using a heuristic optimization approach based on L2 regularization, we were able to obtain a unique set of realistic growth rates that corresponded well with observed replication rates. We integrated adjustable dietary and taxon abundance constraints to generate personalized metabolic models for individual metagenomic samples. We applied MICOM to a balanced cohort of …

Biogeographic Study Of Human Gut-Associated Crassphage Suggests Impacts From Industrialization And Recent Expansion, Tanvi P/ Honap, Krithivasan Sankaranarayanan, Stephanie L. Schnorr, Andrew T. Ozga, Christina Warinner, Cecil M. Lewis Jr.

Anthropology Faculty Research

CrAssphage (cross-assembly phage) is a bacteriophage that was first discovered in human gut metagenomic data. CrAssphage belongs to a diverse family of crAss-like bacteriophages thought to infect gut commensal bacteria belonging to Bacteroides species. However, not much is known about the biogeography of crAssphage and whether certain strains are associated with specific human populations. In this study, we screened publicly available human gut metagenomic data from 3,341 samples for the presence of crAssphage sensu stricto (NC_024711.1). We found that crAssphage prevalence is low in traditional, hunter-gatherer populations, such as the Hadza from Tanzania and Matses from Peru, as compared to …

Increased Episodes Of Aspiration On Videofluoroscopic Swallow Study In Children With Nasogastric Tube Placement., Sarah T. Edwards, Linda Ernst, Ashley K. Sherman, Ann M. Davis

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Given the limited evidence available, the impact of nasogastric (NG) tube placement on swallowing in children is not well understood. When a child needs to be fed enterally, the current standard is to initially place an NG tube and leave it in place for the first few months of supplemental or total enteral nutrition. It is important to understand if placement of NG tubes has a negative effect on a patient's swallow.

METHODS: We retrospectively reviewed the charts of those children who had videofluoroscopic swallow studies (VFSS) to identify all children who had an NG tube in place at …

Preparation In The Big Apple: New York City, A New Epicenter Of The Covid-19 Pandemic, S. A. Gross, D. H. Robbins, D. A. Greenwald, F. H. Schnoll-Sussman, M. B. Pochapin

Journal Articles

No abstract provided.

Use Of Omental Patch And Endoscopic Closure Technique As An Alternative To Surgery After Endoscopic Full Thickness Resection Of Gastric Intestinal Stromal Tumors: A Series Of Cases, A. H. Sachdev, S. Iqbal, I. B. Ribeiro, D. T. De Moura

Journal Articles

© The Author(s) 2020. BACKGROUND Gastrointestinal stromal tumors (GISTs) originate from interstitial cells of Cajal. GISTs can occur anywhere along the gastrointestinal tract. Large lesions have traditionally been removed surgically. However, with recent innovations in advanced endoscopy, GISTs located within the stomach are now removed endoscopically. We describe a new innovative endoscopic technique to close large and hard to access defects after endoscopic full-thickness resection of gastric GISTs. CASE SUMMARY We present a series of three patients who were diagnosed with a gastric GIST. All patients underwent full-thickness endoscopic resection. In all cases, for closure of the surgical bed, conventional …

The Global Impact Of Covid-19 On Gastrointestinal Endoscopy Units: An International Survey Of Endoscopists, M. Alboraie, A. Piscoya, Q. T. Tran, R. B. Mendelsohn, A. S. Butt, L. Lenz, P. Alavinejad, M. H. Emara, S. Iqbal, S. Vignesh, +10 Additional Authors

Journal Articles

© 2020 Pan-Arab Association of Gastroenterology Background & study aims: Corona virus disease-19 (COVID-19) pandemic has markedly impacted routine medical services including gastrointestinal (GI) endoscopy. We aim to report the real-life performance in high volume GI endoscopy units during the pandemic. Patients and methods: A web-based survey covering all aspects of daily performance in GI endoscopy units was sent to endoscopy units worldwide. Responses were collected and data were analyzed to reveal the effect of COVID-19 pandemic on endoscopy practice. Results: Participants from 48 countries (n = 163) responded to the survey with response rate of 67.35%. The majority (85%) …

Gastrointestinal Endoscopy During The Coronavirus Pandemic In The New York Area: Results From A Multi-Institutional Survey., S. Mahadev, O. C. Aroniadis, L. H. Barraza, E. Agarunov, M. S. Smith, A. J. Goodman, P. C. Benias, J. M. Buscaglia, S. A. Gross, T. A. Gonda, +6 Additional Authors

Journal Articles

Background and study aims  The coronavirus disease 2019 (COVID-19), and measures taken to mitigate its impact, have profoundly affected the clinical care of gastroenterology patients and the work of endoscopy units. We aimed to describe the clinical care delivered by gastroenterologists and the type of procedures performed during the early to peak period of the pandemic. Methods  Endoscopy leaders in the New York region were invited to participate in an electronic survey describing operations and clinical service. Surveys were distributed on April 7, 2020 and responses were collected over the following week. A follow-up survey was distributed on April 20, …

Acute Appendicitis Review: Background, Epidemiology, Diagnosis, And Treatment., M. Krzyzak, S. M. Mulrooney

Journal Articles

Appendicitis is a common occurrence in both the adult and pediatric populations. The condition most commonly occurs between the ages of 10 and 20 years with a lifetime risk of 8.6% and 6.7% for males and females respectively. Its diagnosis focuses on clinical presentation and imaging modalities classified according to scoring systems such as the Alvarado scoring system. A number of imaging modalities can be used, with CT being the most common one. For acute appendicitis, surgical intervention is considered to be the gold standard of treatment. However, recent research has focused on other modalities of treatment including antibiotics and …

Comparative Safety And Effectiveness Of Vedolizumab To Tumour Necrosis Factor Antagonist Therapy For Crohn's Disease, M. Bohm, R. Xu, Y. Zhang, S. Varma, M. Fischer, G. Kochhar, B. Boland, S. Singh, A. Swaminath, S. Chablaney, +26 Additional Authors

Journal Articles

© 2020 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd Background: Direct comparisons are lacking between vedolizumab and tumour necrosis factor (TNF)-antagonist therapy in Crohn's disease (CD). Aim: To compare safety and effectiveness of vedolizumab and TNF-antagonist therapy in adult CD patients. Methods: Retrospective observational cohort (May 2014–December 2017) propensity score-weighted comparison of vedolizumab vs TNF-antagonist therapy (infliximab, adalimumab, certolizumab) in CD. Propensity scores were weighted for age, prior treatments, disease complications, extent and severity, steroid dependence, and concomitant immunosuppressive drug use. The primary outcome was comparative risk for infections or non-infectious serious adverse events …

Development And Validation Of Clinical Scoring Tool To Predict Outcomes Of Treatment With Vedolizumab In Patients With Ulcerative Colitis., P. S. Dulai, S. Singh, N. V. Casteele, J. Meserve, A. Winters, S. Chablaney, S. Aniwan, P. Shashi, A. Swaminath, C. Cao, +10 Additional Authors

Journal Articles

BACKGROUND & AIMS:We created and validated a clinical decision support tool (CDST) to predict outcomes of vedolizumab therapy for ulcerative colitis (UC). METHODS:We performed logistic regression analyses of data from the GEMINI 1 trial, from 620 patients with UC who received vedolizumab induction and maintenance therapy (derivation cohort), to identify factors associated with corticosteroid-free remission (full Mayo score of 2 or less, no subscore above 1). We used these factors to develop a model to predict outcomes of treatment, which we called the vedolizumab CDST. We evaluated the correlation between exposure and efficacy. We validated the CDST in using data …

Depression Is Associated With Weight Gain In Patients Transplanted For Nash Cirrhosis But Not Other Etiologies Of Cirrhosis, Jose Hernandez-Roman, Steven Shen, Samarth Patel, Mohammad Bilal Siddiqui, Anchalia Chandrakumaran, Masoud Faridnia, Emily Zhang, Emily Lee, Mohammad Shadab Siddiqui

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

The present study was to bridge this gap in knowledge by evaluating the relationship between depression, liver disease and weight change after LT. Weight gain after liver transplantation (LT) is common, particularly in patients transplanted for NASH cirrhosis, and is associated with reduced survival. In non-LT patients, presence and sub-optimal management of depression is closely associated with weight gain and obesity. The impact of depression as predictor of post-LT weight gain is currently not known. Method:All adult patients receiving LT between 7/2007 to 7/2017 were included in the analysis. Patients with graft failure or death within 6 months after …

Endoscopic Evaluation Of Inflammatory Bowel Disease With High-Grade Dysplasia Should Not Be Delayed During The Covid-19 Pandemic: A Case Report, K. L. Raphael, A. J. Trindade, H. M. Zimmerman, K. S. Sultan

Journal Articles

No abstract provided.

Management Of Upper Gi Bleeding In Patients With Covid-19 Pneumonia, K Cavaliere, C Levine, P Wander, Dv Sejpal, Aj Trindade

Journal Articles

No abstract provided.

Elective Endotracheal Intubation For Urgent Gastrointestinal Endoscopy Among Hospitalized Patients With Sars-Cov-2, P Wander, De Hogan, S Inamdar, Pc Benias, F Haddad, S Andrawes, De Bernstein, D V. Sejpal, A J. Trindade

Journal Articles

No abstract provided.

Prevalence, Risk Factors, And Outcomes Of Hospitalized Patients With Covid-19 Presenting As Acute Pancreatitis., S. Inamdar, P. C. Benias, Y. Liu, D. V. Sejpal, S. K. Satapathy, A. J. Trindade, Northwell Covid-19 Research Consortium

Journal Articles

No abstract provided.

Management Of Upper Gi Bleeding In Patients With Covid-19 Pneumonia, K. Cavaliere, C. Levine, P. Wander, D. V. Sejpal, A. J. Trindade

Journal Articles

No abstract provided.

Polycystic Liver With Cardiac Compression Leading To Atrial Fibrillation: Case Report And Review Of The Literature., A. Elfiky, C. T. El Imad, B. Karam, S. M. Mulrooney

Journal Articles

Polycystic liver disease (PCLD) is a rare condition that most often occurs in patients with polycystic kidney disease and less commonly as an isolated liver disease. Complications include cyst rupture, infection, hemorrhage, and compression of surrounding organs by large cysts. We present the case of a patient with a history of PCLD who presented to our hospital with palpitations and was found to have atrial fibrillation. Imaging and echocardiograph revealed a dominant large cyst compressing the right atrium. Other etiologies including thyroid disease, ischemic heart disease, and electrolytes abnormalities were excluded. The patient refused surgical intervention and was conservatively treated …

Over-The-Scope Clip To The Rescue! A Novel Tool For Refractory Acute Nonvariceal Upper Gastrointestinal Hemorrhage, S. Amarnath, H. Khan, J. Philipose, J. Abergel

Journal Articles

© 2020 © 2020 The Author(s). Published by S. Karger AG, Basel. Nonvariceal upper gastrointestinal hemorrhage (NVUGIH) is more prevalent than lower gastrointestinal hemorrhage and carries a high risk of mortality in the elderly, especially those with significant cardiovascular comorbidities. Traditional endoscopic methods, such as through-the-scope clips, electrocautery, and epinephrine injection, are frequently used to control these bleeds; however, they carry a 10% risk of rebleeding, and this itself carries a mortality risk of 36%. The larger over-the-scope clips (OTSC) that were initially used for the closure of fistulas and perforations are now gradually being implemented to manage NVUGIH. To …

Donning A New Approach To The Practice Of Gastroenterology: Perspectives From The Covid-19 Pandemic Epicenter., A. Sethi, A. Swaminath, M. Latorre, D. S. Behin, D. Jodorkovsky, D. Calo, A. Mone, D. H. Robbins, +9 Additional Authors

Journal Articles

The COVID-19 pandemic seemingly is peaking now in New York City and has triggered significant changes to the standard management of gastrointestinal diseases. Priorities such as minimizing viral transmission, preserving personal protective equipment, and freeing hospital beds have driven unconventional approaches to managing gastroenterology (GI) patients. Conversion of endoscopy units to COVID units and redeployment of GI fellows and faculty has profoundly changed the profile of most GI services. Meanwhile, consult and procedural volumes have been reduced drastically. In this review, we share our collective experiences regarding how we have changed our practice of medicine in response to the COVID …

Delay In Diagnosis Of Barrett's Esophagus Cancer During The Covid-19 Pandemic: Lessons Learned., A. J. Trindade, A. Rishi

Journal Articles

No abstract provided.

Development And Validation Of Clinical Scoring Tool To Predict Outcomes Of Treatment With Vedolizumab In Patients With Ulcerative Colitis., Parambir S Dulai, Siddharth Singh, Niels Vande Casteele, Joseph Meserve, Adam Winters, Shreya Chablaney, Satimai Aniwan, K. Sultan, A. Swaminath, Charlie Cao, +30 Additional Authors

Journal Articles

BACKGROUND & AIMS: We created and validated a clinical decision support tool (CDST) to predict outcomes of vedolizumab therapy for ulcerative colitis (UC).

METHODS: We performed logistic regression analyses of data from the GEMINI 1 trial, from 620 patients with UC who received vedolizumab induction and maintenance therapy (derivation cohort), to identify factors associated with corticosteroid-free remission (full Mayo score of 2 or less, no subscore above 1). We used these factors to develop a model to predict outcomes of treatment, which we called the vedolizumab CDST. We evaluated the correlation between exposure and efficacy. We validated the CDST in …

Eus Assessment For Intermediate Risk Of Choledocholithiasis After A Negative Magnetic Resonance Cholangiopancreatography, D. Wee, S. Izard, G. Grimaldi, K. Raphael, T. P. Lee, A. Trindade

Journal Articles

© 2020 SPRING MEDIA PUBLISHING CO. LTD | PUBLISHED BY WOLTERS KLUWER - MEDKNOW 291. Background and Aims: Guidelines recommend either EUS or magnetic resonance cholangiopancreatography (MRCP) for intermediate risk of choledocholithiasis. There is a lack of evidence that supports proceeding with EUS if the MRCP is negative and if clinical suspicion still exists. Methods: This is a retrospective study of all patients who underwent EUS to assess for choledocholithiasis at a tertiary care referral center from July 2013 to October 2019. Results: A total of 593 patients underwent EUS for evaluation for choledocholithiasis. Of the 593 patients, 35.2% (209/593) …

Endoscopic Submucosal Tunnel Dissection As A Novel Therapeutic Technique In Patients With Barrett’S Esophagus, F. Inayat, S. Weissman, A. Malik, B. Munir, S. Iqbal

Journal Articles

© 2020 American Federation for Medical Research. With the ameliorated resectability prowess of endoscopic techniques, a myriad of diseases previously treated by major ablative surgeries are now endoscopically curable. Endoscopic submucosal tunnel dissection (ESTD) is a relatively new technique that has diversified endoscopic application. Although ESTD has frequently been used for the resection of esophageal neoplastic lesions, the clinical evidence pertaining to its efficacy in the treatment of circumferential Barrett’s esophagus remains sparse. In this study, we evaluated ESTD as a potential therapeutic technique in patients with Barrett’s esophagus-related high-grade dysplasia. The tunneling strategy helped achieve complete en bloc resection …

Presentation And Outcomes Among Inflammatory Bowel Disease Patients With Concurrent Pneumatosis Intestinalis: A Case Series And Systematic Review, Y. Gao, M. Uffenheimer, M. Ashamallah, G. Grimaldi, A. Swaminath, K. Sultan

Journal Articles

© 2020 Korean Association for the Study of Intestinal Diseases. Background/Aims: Inflammatory bowel disease (IBD) involves chronic inflammation of the colon with ulcerative colitis (UC), and the colon and/or small intestine with Crohn's disease (CD). Pneumatosis intestinalis (PI), characterized by compromise of the intestinal wall with gas-filled cysts, has rarely been reported with IBD. The presentation, best management and outcomes of PI with IBD are poorly defined. Methods: We conducted a search for PI in all abdominal computed tomography (CT) reports at 2 large tertiary care hospitals from January 1, 2010 to December 31, 2017, cross referenced to ICD codes …

The Course Of Sars-Cov2 Infection Was Not Severe In A Crohn's Patient Who Administered Maintenance Anti-Tnf Therapy Overlapping The Early Pre-Symptomatic Period Of Infection., F. Okeke, A. Mone, A. Swaminath

Journal Articles

The Inflammatory Bowel Disease (IBD) population, which may require treatment with immunosuppressive medications, may be uniquely vulnerable to COVID-19 infection. In fact, there is some evidence these medications may inhibit the cytokine storm that is theorized to cause a rapid decline seen in COVID-19. In addition, the digestive symptoms of COVID-19 can be difficult to distinguish from the activation of IBD. We present an interesting case of a Crohn's patient inadvertently administering anti-cytokine therapy during the pre-symptomatic period of COVID-19 infection. Immune suppression during early infection with SARS-COV2 risks a poor immune response to the virus and could theoretically result …

Roth Net-Assisted Endoscopic-Guided Manometry Catheter Placement., D. Gurala, J. Philipose, A. D. Polavarapu, Y. El Douaihy, S. M. Mulrooney

Journal Articles

High-resolution esophageal manometry (HRM) has become the gold standard to diagnose esophageal motility disorders. Usually, this procedure is performed by introducing the catheter, which has pressure sensors, into the esophagus and proximal stomach via the nares. Repeated coiling of the catheter and inability to pass through the gastroesophageal junction (GEJ) are common challenges encountered. Endoscopy-guided placement of the catheter can overcome these difficulties. However, sometimes even with the use of endoscopy, it is difficult to advance catheter due to anatomical variants. The extreme fragility of the catheter and sensors and the high cost of this reusable device precludes the use …