Digestive System Diseases Commons^™

The Role Of Heart Rate Variability In The Management Of Inflammatory Bowel Disease: A Scoping Review, Zarif A. Ladak, Krisha Patel, Dylan Bagley, Jeffery Powers

Rowan-Virtua Research Day

Complications associated with Inflammatory Bowel Disease (IBD) have an unclear pathophysiology. Heart Rate Variability (HRV) is a potent modality for monitoring autonomic nervous system function and may give insight into the timing of flares and complication development. Existing literature suggests a link between IBD complications and inflammation as well as inflammation and HRV. However, research directly exploring the relationship between HRV and IBD complications is limited. This review aims to examine the state of the science as it pertains to the relationship between HRV and IBD complications highlighting current knowledge gaps to guide future research. A search was conducted using …

Children Born To Mothers With Inflammatory Bowel Disease: A Review Of Pediatric Outcomes, Simran Gandhi, Kush Patel, Harmann Singh

Rowan-Virtua Research Day

Background: Inflammatory Bowel Disease (IBD), comprising Crohn’s disease and ulcerative colitis, frequently affects women during their reproductive years. While the impact of IBD on pregnancy has been widely studied, less is known about the long-term health outcomes in children born to affected mothers, particularly in the context of in utero exposure to immunosuppressive therapies.

Hypothesis: We hypothesize that children born to mothers with well-managed IBD experience normal growth and development, with minimal risk for immune-related complications, despite potential exposure to biologics and other IBD medications during gestation.

Methods: A literature review was conducted using PubMed and Google Scholar. Search terms …

The Presence Of Cardiac Arrhythmias Impacts Hospitalized Patients With Celiac Disease, Rahul Patel, Tirth Patel, Darshan Patel, Trinava Roy, Sachin Prasad, Paul Gill, Rafail Beshai, Joshua Soliman, Brian Blair, C. Jonathan Foster

Rowan-Virtua Research Day

Background

Celiac disease has links to inflammatory bowel disease (IBD), rheumatoid arthritis (RA), and sarcoidosis. The latter 3 also have cardiovascular manifestations associated with them. However, there are limited studies on the in-hospital outcomes of Celiac disease with cardiac manifestations. Therefore, the aim of this study was to evaluate the hospital outcomes of Celiac disease with concomitant arrhythmias.

Methods

Patients aged 18 years with Celiac disease and arrhythmias (atrial fibrillation, atrial flutter, ventricular tachycardia, and supraventricular tachycardia) versus Celiac Disease alone were identified from the US Nationwide Inpatient Sample (NIS), from the years 2019-2020. ICD 10 codes were utilized. Multivariate …

Unusual Path: Gallstone Ileus With Pneumobilia And Jejunal Obstruction, Kristine Rubi, Kelly Schuitema, Russell Mordecai, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We present a case of a 48-year-old female with two-day history of diffuse abdominal pain, nausea and vomiting. She was diagnosed with small bowel obstruction due to gallstone ileus. Diagnosis is usually challenging due to its nonspecific presentation, but computed tomography reveals the classic findings of Rigler’s triad -- pneumobilia, bowel obstruction, and an ectopic gallstone. The patient underwent laparoscopy with enterolithotomy with subsequent resolution of symptoms. Prompt diagnosis through imaging and timely surgical intervention is critical for in preventing complications and improving patient outcomes.

Clinical Implications Of Mismatch Repair Deficiency In Pancreatic Ductal Adenocarcinoma, Zachary Kaplan, Elizabeth Prezioso, Aditi Jain, Harish Lavu, Charles Yeo, Wilbur Bowne, Avinoam Nevler

Kimmel Cancer Center Faculty Papers

BACKGROUND: Pancreatic cancer is a highly aggressive and lethal disease, characterized by a limited response to chemotherapy and overall poor prognosis. Pancreatic cancers with a distinct mismatch repair deficiency, although relatively rare, have been shown to be associated with markedly better outcomes in comparison. Furthermore, whereas pancreatic cancers are generally unresponsive to current immunotherapy, this specific group of tumors has been shown to have a notable susceptibility to immune checkpoint inhibitors.

AIMS: In this review, we aim to summarize the relevant literature regarding mismatch-repair associated pancreatic cancers, the impacted biological mechanisms, and the resulting vulnerabilities for potential opportunistic immunotherapeutic treatment …

The Role Of Ucp2 In Pancreatic Cancer Metabolism And Its Potential As A Radiosensitizer, Emily Rieff

Dissertations and Theses (Open Access)

Uncoupling protein 2 (UCP2) is a mitochondrial protein that regulates the flow of protons down the gradient established by the electron transport chain (ETC) without generating ATP, thus uncoupling the proton gradient from ATP generation. In tumors, specifically pancreatic cancer (PDAC), the ETC is highly stimulated to generate the copious ATP needed by the tumor to grow. However, extended ETC use increases reactive oxygen species (ROS), and if left unchecked, results in cell death. To evade this, PDAC employs antioxidant strategies, including upregulating UCP2 in tumor cells. In addition to its uncoupling function, UCP2 indirectly controls ROS levels by maintaining …

Multiparametric Mri Scoring System Of The Pancreas For The Diagnosis Of Chronic Pancreatitis, Temel Tirkes, Dhiraj Yadav, Darwin L Conwell, Xuandong Zhao, Anil K Dasyam, Vivek Gowdra Halappa, Aashish Patel, Zarine K Shah, Jordan Swensson, Naoki Takahashi, Sudhakar Venkatesh, Ashley Wachsman, Liang Li, Kristofer Jennings, Yunlong Yang, Phil A Hart, Stephen J Pandol, Walter G Park, Santhi Swaroop Vege, Mark Topazian, Paul R Territo, Scott A Persohn, Dana K Andersen, Evan L Fogel, Consortium For The Study Of Chronic Pancreatitis, Diabetes, And Pancreatic Cancer (Cpdpc)

Faculty, Staff and Student Publications

Background: Ductal features alone may not offer high diagnostic sensitivity or most accurate disease severity of chronic pancreatitis (CP).

Purpose: Diagnose CP based on multiparametric MRI and MRCP features.

Study type: Prospective.

Population: Between February 2019 and May 2021, 46 control (23 males, 49.3 ± 14.1 years), 45 suspected (20 males, 48.7 ± 12.5 years), and 46 definite (20 males, 53.7 ± 14.6 years) CP patients were enrolled at seven hospitals enrolled in the MINIMAP study. CP classification was based on imaging findings and clinical presentation.

Field strength and sequences: 1.5 T. T1-weighted (T1W) spoiled gradient echo, T1 map with …

The Role Of Myosin 5b In Intestinal Health And Disease: From Microvilli Assembly To Colorectal Cancer Progression, Sarah Aline Dooley

MUSC Theses and Dissertations

Background: Myosin Vb (Myo5b) is an essential molecular motor responsible for delivering diverse cargo to the apical membrane of enterocytes. Mutations in Myo5b cause congenital enteropathies, but its broader role in maintaining the integrity of the intestinal brush border under normal physiological conditions and in disease remain unclear. We hypothesize that Myo5b participates in the assembly and maintenance of the intestinal brush border by transporting members of the intermicrovillar adhesion complex (IMAC) and the xenobiotic efflux pump P-glycoprotein (P-gp) to the apical membrane of enterocytes. We further hypothesize that dysregulation of the myosin chaperone protein, UNC45A, and downregulation of Myo5b …

The Role Of Biological Sex In The Treatment Of Acute Cholecystitis, Desiree Duncan, Camden Gardner, Polina Chuikov, Matthew George, Sadaf Hashemian, Jeffrey Johnson, Md

Medical Student Research Symposium

Background

Some patients with symptomatic gallstones present with more severe disease, have more difficult anatomy and require more complex operations. While cholecystitis has a female preponderance, some observe a trend towards more challenging disease in male patients. The confluence of gender and patient acuity has not been thoroughly investigated. We hypothesize that males present with worse disease compared to females.

Methods

The analysis cohort of adults who underwent cholecystectomies was filtered from a five-hospital health system administration registry containing inpatients admitted from Fall 2015 to Fall 2021. The dataset contained demographics, health characteristics, and variables reflecting disease severity and acuity. …

1st Place Contest Entry: Effectiveness Of Intravesical Bcg In The Treatment Of Nonmuscle Invasive Bladder Cancer: An Umbrella Review, Gerald Obinna Ozota

Eric M. Scandrett Graduate Library Research Prize

This is Gerald Obinna Ozota's submission for the 2025 Eric M. Scandrett Graduate Research Prize, which won first place. It contains their essay on using library resources, their bibliography, and a summary of their research project on conducting a systematic literature search to identify all relevant systematic reviews and meta-analyses investigating the effectiveness of intravesical Bacillus Calmette-Guerin (BCG) on Non-muscle-invasive Bladder Cancer (NIMBC).

Gerald is a student in the Ph.D. in Pharmaceutical Sciences program at Chapman University. Their faculty mentor is Dr. Lawrence Brown.

The Impact Of Obesity Vs Non-Obesity Body Mass Index (Bmi) On Adalimumab Efficacy In Ulcerative Colitis, Mekhala Santebennur, Kathryn Mozzochi, Diana Gavilanes Md, Evelyn J. Calderon Martinez Md, Anas Atrash Md

Tower Health Research Day

No abstract provided.

Effect Of Chronic Alcohol Feeding Using The Lieber-Decarli Diet On Alzheimer’S Disease Pathology In Tg2576 Mice, Devaraj V. Chandrashekar, Nataraj Jagadeesan, Tamara Abdullah, Rudy Chang, Ross A. Steinberg, Frankey Sanchez, Elias Khal, Joshua Yang, David H. Cribbs, Derick Han, Rachita K. Sumbria

Pharmacy Faculty Articles and Research

Background: Chronic alcohol drinking is a modifiable risk factor for Alzheimer’s disease (AD), but underlying mechanisms remain poorly understood. Most studies of alcohol feeding to AD mice have utilized young mice and delivered alcohol in drinking water without controlling nutritional intake.

Objective: To study the impact of Lieber-DeCarli (LDC) liquid alcohol diet, which balances nutritional intake, on AD pathology of aged Tg2576 and wild-type (WT) mice, which is unexplored.

Methods: 13-month-old male and female Tg2576 or WT mice were fed LDC diet (5% ethanol or control) for six weeks (n = 11-13/group). Exploration (open-field test) and spatial reference memory …

Cracking The Code Of Hbv Persistence: Cutting-Edge Approaches To Targeting Cccdna In Chronic Hepatitis B With Or Without Pyogenic Liver Abscesses, Umar Saeed, Zahra Zahid Piracha, Mahmood Khan, Muhammad Nouman Tariq, Syed Shahan Gilani, Muhammad Raza, Rakshana Munuswamy, Naveen Bose, Dilber Uzun Ozsahin, Ilker Özşahin, Surya M. Nauli

Pharmacy Faculty Articles and Research

Chronic Hepatitis B Virus (HBV) infection remains a formidable global health challenge, driving severe liver complications such as hepatocellular carcinoma (HCC) and pyogenic liver abscesses (PLA). At the core of HBV persistence lies covalently closed circular DNA (cccDNA), a viral reservoir that fuels ongoing infection despite antiviral treatments. This review highlights molecular mechanisms governing cccDNA formation, maintenance, and clearance, spotlighting innovative therapeutic strategies to disrupt this key viral element. We explore cutting-edge approaches, including epigenetic modulation to silence cccDNA, RNA interference (RNAi) for viral RNA degradation, and CRISPR/Cas genome editing to excise cccDNA directly. Additionally, emerging antiviral therapies and immunotherapies, …

A Case Of Turmeric-Induced Hepatotoxicity With Hyperferritinemia, Nina R. Spitofsky, Albert A. Huang, Aria Jalalian, Stefanie Gallagher, Scott Fink

Department of Medicine Faculty Papers

Introduction: We present the first published case of turmeric-associated drug-induced liver injury (DILI) accompanied by significant ferritin elevation. Case Presentation: Our patient, a 59-year-old female with DILI caused by long-term ingestion of oral turmeric supplements, presented with painless jaundice on an annual exam. The patient’s liver function tests exhibited a hepatocellular pattern and hyperferritinemia (>2,000 ng/dL). Additional testing was negative except for heterozygosity for the H63D allele associated with hemochromatosis. A liver biopsy indicated acute hepatitis without fibrosis or stainable iron. Conclusion: Upon discontinuation of the supplement, liver enzymes normalized within a month. This case highlights the potential for …

A Case Of Microscopic Colitis Masquerading As Chronic Inflammatory Diarrhea, Corey Haines, Sophia Moon, Giani Tah, Diana Acosta Pozo, Alejandro Aquino, Fatimah Bello

Research Symposium

Introduction: Microscopic colitis is an idiopathic, inflammatory form of colitis that is characterized by a normal macroscopic appearance of bowel but abnormal histological appearance on microscopy. Microscopic colitis can be subdivided into two histological subtypes: collagenous and lymphocytic. The collagenous subtype is characterized by proliferation of collagenous connective tissue that forms a thick subepithelial collagen band while the lymphocytic subtype is characterized by lymphocytic infiltrates and little to no proliferation of connective tissue. Classically, microscopic colitis presents with chronic, nonbloody, watery diarrhea lasting more than one month. It is typically associated with weight loss, abdominal pain, tenesmus, and nocturnal stools. …

Terlipressin-Induced Hyponatremic Seizures In A Patient With Congenital Hepatic Fibrosis, Luca Gauci, Jorge Gafa, Suzanne Cauchi, Jurgen Gerada

HCA Healthcare Journal of Medicine

Introduction

Acute variceal bleeding from portal hypertension is one of the most serious complications with a mortality rate of 15% to 25%. Terlipressin is a vasopressor that controls variceal bleeding by lowering the portal pressure and reducing blood flow to the varices.

Case Presentation

We report a case of a patient with acute variceal bleeding, treated endoscopically and with terlipressin, who developed severe hyponatremia and seizures requiring admission to intensive care. Clinical and biochemical improvements were noticeable upon the cessation of terlipressin, with an eventual discharge from the hospital.

Conclusion

Prompt management of acute variceal bleeding with both endoscopic and …

The Association Of Physical Activity With Survival In Colon Cancer Versus A Matched General Population: Data From Cancer And Leukemia Group B 89803 And 80702 (Alliance)., Justin C. Brown, Chao Ma, Qian Shi, Leonard B. Saltz, Anthony F. Shields, Jeffrey A. Meyerhardt

School of Medicine Faculty Publications

Background: Colon cancer patients have inferior overall survival than a matched general population (MGP). It is unknown if physical activity is associated with a reduction in this survival disparity. Methods: Data were analyzed from two National Cancer Institute–sponsored postoperative treatment trials in stage III colon cancer, Cancer and Leukemia Group B (CALGB) 89803 and 80702, with 2876 patients who self-reported physical activity. Physical activity was converted to metabolic equivalents (MET-hours/week). The MGP was derived from the National Center for Health Statistics and matched on age, sex, and year. Results: In CALGB 89803, among patients who were alive at 3 years, …

Silencing Faf2 Mitigates Alcohol-Induced Hepatic Steatosis By Modulating Lipolysis And Pcsk9 Pathway, Nazmul Huda, Praveen Kusumanchi, Yanchao Jiang, Hui Gao, Themis Thoudam, Ge Zeng, Nicholas J. Skill, Zhaoli Sun, Suthat Liangpunsakul, Jing Ma, Zhihong Yang

School of Medicine Faculty Publications

BACKGROUND: Chronic alcohol consumption leads to lipid accumulation, oxidative stress, cellular damage, and inflammation in the liver, collectively referred to as alcohol-associated liver disease (ALD). FAF2/UBXD8/ETEA (Fas-associated factor 2) is a ubiquitin ligase adaptor protein that plays a crucial role in the ubiquitin-mediated degradation of misfolded proteins in the endoplasmic reticulum. A recent genome-wide association study indicated an association between FAF2 and ALD; however, the exact contribution of FAF2 to ALD pathogenesis remains unclear. METHODS: FAF2 was knocked down using AAV-delivered shRNA in C57/BL6 mice. Mice were subjected to a chronic-plus-single binge ethanol feeding (NIAAA) model. Nine hours after gavage, …

The First International Experience With Histotripsy: A Safety Analysis Of 230 Cases, Chase J. Wehrle, Kevin Burns, Evan Ong, Allison Couillard, Neehar D. Parikh, Elaine Caoili, Jaekeun Kim, Federico Aucejo, Andrea Schlegel, Emily Knott, Paul Laeseke, J Philip Boudreaux, Philipp Von Breitenbuch, Mikhail Silk, Mohamed Alassas, Andrew Guzowski, Brian Fuller, Erica Knavel Koepsel, Brock Hewitt, Mishal Mendiratta-Lala, David C. Kwon

School of Medicine Faculty Publications

BACKGROUND: Histotripsy is a novel, noninvasive, nonionizing, and nonthermal approach that uses focused ultrasound waves to treat liver tumors. This technology received a de novo Food and Drug Administration grant in late 2023. This study aimed to provide the first report on post-trial real-world clinical safety data. METHODS: Safety outcomes within 30 days of histotripsy were collected after obtaining Food and Drug Administration clearance (December 22, 2023 to July 26, 2024). All centers that performed histotripsy were invited to participate in this study. Complications requiring treatment were graded using the Clavien-Dindo classification and Comprehensive Complication Index (CCI). RESULTS: A total …

The Oral-Gut Microbiome Axis: Implications For Systemic And Oral Health, Sana Shariff, Manas Mandal

Annual Research Symposium

The bidirectional relationship between the oral and gut microbiomes has gained attention for its role in systemic and oral diseases. Dysbiosis, or microbial imbalance, disrupts these ecosystems, leading to inflammatory conditions. This research investigates the connection between these microbiomes, focusing on microbial translocation, disease correlation, and targeted interventions such as probiotics or dietary modifications to restore microbial homeostasis and reduce disease incidence.